Jejunostomy
(feeding tube in the small bowel)
When functional
recovery of the stomach is not to be expected soon after surgery, implantation
of a catheter for enteral feeding can be considered. In this way special
prepared nutritional fluids can be administered to achieve a better nutritional
state and therefore better healing.
Parenteral administration (intravenously) is also possible, but is less
effective.
A description of the technique is given.
1
2
3
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5
6
7
During surgery a hollow needle is introduced through the skin in the abdomen. Then the needle is withdrawn (1,2). Another hollow needel is used to puncture the small bowel wall. After introduction of a blunt inner part, the needle is forwarded in the wall of the small bowel (3-7)
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10
11
12
13
Then the lumen of the small bowel is entered with the needle and the blunt part of the needle is removed. Introduction of the catheter through the hollow part follows and the needle is withdrawn from the bowel. The needle is split and removed (8-10). To keep the catheter from falling out of the bowel (which is moving almost all the time), a suture is placed around the entry of the catheter in the bowel and a tunnel is created by suturing the bowel wall over the catheter (11-13).
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15
16
This part of the bowel is then fixed to the abdominal wall. This is also meant to get a better fixation (14-16).
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19
20
The catheter is prepared with several devices to allow connection to an infusion device. At the entry place through the skin fixation with sutures give additional support (17-20).