Fig. 2

Stepwise procedures of laparoscopic feeding jejunostomy. a Two fixation stiches were made between the peritoneal surface of the cutaneous exit and the proximal jejunum, which was usually about 15 to 20 cm distal to the Treitz ligament. A small enterotomy was made by monopolar electrocautery at an appropriate location just opposite to the cutaneous exit. b A skin incision was made at the predetermined cutaneous exit and one 14Fr feeding tube was inserted through this incision into the distal jejunum. The tube was advanced to a designated length and one purse-string sero-muscular suture around the tube was performed. c Several more interrupted peritonization sutures were carried out to approximate the jejunum to the peritoneal side of the anterior abdominal wall. d The feeding tube was finally tested for patency and leakage after these procedures