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Laparoscopic-Assisted Takedown of a Gastrocutaneous Fistula

Laparoscopic-Assisted Takedown of a Gastrocutaneous Fistula
Victoria J. Grille, MD1Eric M. Pauli, MD, FACS, FASGE2
1Jersey Shore University Medical Center
2Penn State Milton S. Hershey Medical Center

A gastrocutaneous fistula is an abnormal connection between the stomach and skin, most commonly occurring after removal of a gastrostomy feeding tube. This video demonstrates the surgical technique of laparoscopic takedown of a gastrocutaneous fistula, performed in conjunction with upper endoscopy. The patient is a pediatric patient with a history of gastrostomy tube placement and Nissen fundoplication for reflux during infancy. Despite removal of the tube, the fistula persisted. Prior endoscopic interventions, including over-the-scope clip placement, were unsuccessful. Due to ongoing drainage and patient preference for definitive closure, surgical intervention was pursued.