Abstract
Regarding gastrostomy for patients with severe motor and intellectual disabiities (SMID), making gastrostoma at accurate site of abdominal wall or stomach can avoid long-term complications. We performed laparoscopic gastrostomy in seven patients with SMID during a two-year and three-month period. Patients were 2 to 41 years old. Among these, five received gastrostomy, one received re-gastrostomy, and one received Nissen’s fundoplication and gastrostomy. We could gastrostomy at the appropriate site of stomach even towards elder patients with severe deformation by laparoscopic surgery with increased ports. Pre-operative marking of the appropriate gastrostomy site while the patient was in the half-sitting position was useful to determine the appropriate site of the abdominal wall. During laparoscopic operations, via traction of the stomach, gastrostomy at the appropriate stomach site is feasible even in SMID cases with a highly transformed trunk. All cases had good postoperative courses; no postoperative complications were observed.
