GASTROSTOMY
GASTROSTOMY 1.) Stamm== Temporary, No formation of gastric tube or Tunnel. 2.) Witzel's == Formation of serosal or seromuscular tube or tunnel over the tube. 3.) Janeway == Mostly permanent, Formation of gastric tube/ Tunnel These gastrostomies are fast and relatively safe & can be performed open/Stapled or laparoscopically. But now, these are mostly indicated after failed/dislodged or impossible PEG ( percutaneous endoscopic gastrostomy) & Non- availability of expertise/equipment. Stamm/ Witzel's Gastrostomy: -It is a temporary gastrostomy -For patients who require long-term gastric tube feeding, the Janeway gastrostomy is more convenient than Stamm. Choose a location in the mid-portion of the stomach, closer to the greater curvature than the lesser curvature. Using 2-0 atraumatic PG or silk, insert a circular purse-string suture with a 1.5 cm diameter. -18F to 22F Foley, Malecot/ mushroom catheter inserted (10 to 15cm) into the stomach, tighten purse-string sutur