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Catheter jejunostomy - general and visceral surgery
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Locate the second loop of the jejunum. Here, first puncture the serosa with the second peel-away cannula, then advance the cannula external to the mucosa for a distance of 6-8 cm before puncturing the mucous membrane.
Now insert the catheter into the lumen of the jejunum and remove the peel-away cannula.
Intestinal catheter fixation
Witzel suture line
Covering the catheter insertion site
Fixate the catheter insertion site on the parietal peritoneum of the lateral abdominal wall. This is accomplished by running a continuous purse-string suture around the insertion sites in the visceral and parietal peritoneum. Once this suture is tightened the catheter is covered completely, and the visceral lamina will adhere to the parietal lamina of the peritoneum. This effects optimum protection against secondary catheter dislocation into the free abominal cavity.
Cutaneous catheter fixation