Laparoscopic-assisted 'pull-introducer technique' for gastrostomy tube placement in small infants: A single-centre experience.

Kirberg et al. described in 2016 a one-step gastrostomy tube placement, the 'pull-introducer' technique, designed for small-for-gestational-age neonates, combining two endoscopic techniques. Nine infants (weight 3.4-8.1 kg) in our centre required a gastrostomy placement (two infants) or a combined gastrostomy placement and Nissen fundoplication (seven infants). A single-stage balloon gastrostomy was preferred in all cases because of a significant anaesthetic risk. The pull-introducer method was chosen because the commercially available one-step balloon gastrostomy gastropexy devices were considered too large. There were no immediate or long-term complications (except local infection). All nine infants were discharged from the hospital as planned. After 6 months, the balloon gastrostomy tube was replaced with a balloon button or balloon gastrostomy tube.