The abdominal wall upon completion of the procedure. The external and anchoring sutures are secured to the skin.
Passing the Silastic feeding jejunostomy tube into the lumen of the jejunum and tying the sutures.
Passing one of the dilators through the abdominal wall and into the lumen of the jejunum. Care is taken to pass the dilator just into the lumen of the bowel (under visual laparoscopic control), not far enough to risk posterior intestinal wall perforation.
The anchoring sutures are being placed. The suture is passed through the abdominal wall, a seromuscular bite of intestine is taken, and the suture is then passed out of the abdomen. Four sutures are placed in a diamondshaped configuration, providing both
Trocar placement for laparoscopic jejunostomy.