Читать книгу Gastrointestinal Surgical Techniques in Small Animals - Группа авторов - Страница 73

A single‐access port is inserted in the left side of the abdominal cavity caudal to the last rib. The port is placed lateral to the rectus abdominal muscle. After insufflation of the abdominal cavity a 5 mm rigid endoscope and 5 mm grasping forceps are used to visualize and grab the wall of the body of the stomach toward the fundus between the lesser and greater curvature. The stomach is brought against the abdominal wall and the single‐access port is removed. Small Gelpy retractors are used to keep the incision through the abdominal wall opened. A stay suture is placed in the wall of the stomach. A 3‐0 monofilament absorbable suture is then used to place a purse‐string suture in the wall of the stomach. A #11 blade is used to puncture the center of the purse‐string suture. The gastrostomy tube is then introduced in the lumen of the stomach. The purse‐string suture is tightened around the tube. If a Foley catheter has been used, the balloon is inflated with 5 ml of saline. Four pexy sutures are placed between the wall of the stomach and the transverse abdominalis muscle. A 3‐0 monofilament absorbable suture is used for the pexy. Another purse‐string suture is placed in the transverse abdominalis muscle around the tube to prevent its displacement. The subcutaneous tissue and skin are closed in a routine fashion around the tube. A Chinese finger‐trap suture with 2‐0 nylon is placed on the skin to secure the tube (Song et al. 2008).