Laparoscopic J-Tube Placement

Operation

A laparoscopic jejunostomy tube placement is a minimally invasive approach that involves placement of a feeding tube into the jejunum.  It is performed through several tiny incisions, most of which are less than a centimeter in size.  The proximal part of the jejunum is identified with a laparoscopy.  Four T-fasteners are placed percutaneously into the jejunal lumen.  A needle is placed from the skin, through the abdominal wall into the jejunum.  A wire is placed through the needle into the jejunal lumen and the needle is removed.  Next, an 12F catheter is placed over the wire into the jejunum.  Then the jejunum is drawn up against the abdominal wall by pulling the T-fasteners.

Risks

Laparoscopic jejunostomy tube placement is a safe and effective way to place a feeding tube.  However, when there is a doubt about the anatomy or concern about the amount of adhesions, you surgeon may make a decision to make a traditional incision to complete the operation.  Other complications from the operation are, infection, bleeding and injury to the bowel.

Recovery

After the operation, you will be admitted to the hospital.  Next day, you will be slowly advanced to regular diet.  We will start the tube feeding next day at a low rate and slowly go up to goal.  You will see a nutritionist who will help determine the best formula for you and a case manager will work on setting up getting the equipment and tube feeds to your home.  You will also learn how to use the pump and take care of the feeding tube to prevent clogging.  As long as you are tolerating the tube feeding and your pain is well controlled on liquid pain medication, you will be discharged home.

Long term outcome

When you no longer need the jejunostomy tube, it will be removed in clinic.