Editing Jejunostomy (section)

== '''Laparoscopic technique''' ==

* Camera port and two hand ports in upper abdomen
* 50cm distal to DJ flexure; mark proximal and distal directions
* Do the two posterior quadrant sutures to peritoneum so bowel is hitched up. Easiest thing to do is use trans-fascial suture passer and then clip the sutures externally to allow the bowel to be manipulated.
* Suture with absorbable v-lok in a purse-string, starting front-right and moving anti-clockwise, so knot will be in the front. Don't tie yet.
* Pass the feeding tube into abdomen; make the hole; pass the tube in and inflate balloon
* Tie the purse-string suture
* Do the two anterior quadrant sutures
* Do anti-torsion sutures 5-10cm proximally and distally
* Leak test with water, check to ensure balloon is not over-inflated causing obstruction
* Close