Laparoscopic Repair of Gastric Perforation

The film presents the laparoscopic repair of gastric perforation in 6 year old disabled girl. Perforation was caused by failure replacement of PEG gastrostomy. PEG was implanted typically two years before and currently changed because of its damage. Exchange was done externally by the "old" hole. The narrowed gastrostomy was dilated with dilatators then external PEG button was introduced and balloon filled up. Gastrostomy feeding was started at 1 day after surgery and peritoneal signs occurred immediately. Administration of contrast to the gastrostomy showed leakage of contrast into the abdominal cavity. Visible fine granules in the peritoneal cavity it is Depakine! Postoperative course was uneventful. After 3 months, the patient assumes a typical PEG gastrostomy under the control of laparoscopy to visualize the stomach wall and prevent bowel perforation (adhesions). The procedure was performed in the Department of Pediatric Surgery in Zabrze, Medical University of Silesia, Poland