Controlled percutaneous gastrostomy: nylon T-fastener for fixation of the anterior gastric wall

Abstract

We devised a fixation device using the principles of a garment T-fastener to fix the anterior gastric wall to the abdominal wall for percutaneous gastrostomy. Insertion of large (14-16-F), soft, Foley-type catheters without the problem of buckling of the catheter and/or guide wire into the peritoneum, which has been described by previous methods, is facilitated. Also, fixation of the stomach has prevented leakage of gastric contents into the peritoneum and allows formation of adhesions between the abdominal and gastric walls, similar to surgically placed tubes. We initially used this technique experimentally in five cadaver stomachs and six dogs to determine its feasibility and safety. It has now been successfully performed in ten patients without complications.