Passing the Silastic feeding jejunostomy tube
Passing the Silastic feeding jejunostomy tube into the lumen of the jejunum and tying the sutures.
Dilator through the abdominal wall and into lumen
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.
Construction of mucosa-lined tube
Construction of mucosa-lined tube (Janeway-style gastrostomy). A fold of stomach is elevated and the endoscopic stapler applied. Approximately 1 cm of stomach must be included in the staple line to assure an adequate lumen. The tube is grasped and elevate
