Surgical enteral access

Abstract

Children frequently require surgical access to the gastrointestinal tract for supplemental nutrition in the case of failure to thrive and access for feeding difficulties or GERD, for administration of medications, or for venting of enteric contents. The most common enteral access device is the gastrostomy, but there is sometimes the need for a gastrojejunostomy or for direct jejunal access. There are many techniques available for placement of enteric access devices including open, radiographic, endoscopic, and minimally invasive techniques. There are also a variety of tubes available for placement depending on the needs of the child. Pediatric surgeons are often called upon to place an enteric access devise and therefore need to have several techniques in their armamentarium. These tubes are well designed and generally function well but are prone to technical difficulties, such that we are also called upon frequently to repair or assess a tube placed by us or another caregiver that is not functioning well or has become dislodged.