Catheter jejunostomy - general and visceral surgery

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date of publication: 11.03.2012
  • LMU Klinikum Großhadern

    Prof. Dr. med.  Karl-Walter  Jauch

  • Universitätsklinik Köln

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  • Abdominal paracentesis

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    103-1

    Puncture the right lateral abdominal wall with the peel-away cannula and insert the catheter into the abdominal cavity.

  • Jejunal puncture

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    103-2

    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

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    Advance the catheter about 25 cm into the intestinal lumen and the close the intestinal insertion site of the catheter with a purse string suture.

  • Witzel suture line

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    Cover the purse string suture with several interrupted seroserous sutures.

  • Covering the catheter insertion site

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    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

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    Complete the procedure by suturing the external fixation plate to the skin.