Laparoscopic jejunostomy using T-fasteners as retractors and anchors.

We developed a new technique for performing laparoscopic jejunostomies using T-fasteners to secure the jejunum to the abdominal wall. The proximal jejunum is identified with laparoscopy. Four T-fasteners are introduced percutaneously into the jejunal lumen for retraction, and an 8F catheter is inserted through a peel-away introducer via a J-wire. The jejunum is drawn up against the abdominal wall by pulling on the T-fasteners. Tube placement is checked with laparoscopy and roentgenography. We performed laparoscopic jejunostomies in five patients using this method, and the results were excellent. Jejunostomies can be performed safely, easily, and reliably this way.