Modification of the needle-catheter jejunostomy.

A new technique is described wherein a J-tipped Teflon-coated stainless steel guide wire is used to facilitate the insertion of a needle-catheter jejunostomy tube. The advantages of this technique are that the guide wire is threaded down the bowel much easier than the catheter itself and also that by using the guide wire in threading the catheter over it, the hub need not be amputated, thus reducing the need for additional material to affix or glue a hub onto the catheter after completion of the procedure. Once the technique is mastered, a needle-catheter jejunostomy can be inserted in this fashion in approximately 2 to 3 minutes, thus adding minimal morbidity in terms of operating time. Nutritional support can be started much earlier without the hazard of central venous catheter infection.