Name of the Procedure:

Tube or needle catheter jejunostomy for enteral alimentation, intraoperative, any method
Common name: Jejunostomy

Summary

A jejunostomy is a surgical procedure where a tube or needle catheter is inserted into the jejunum (part of the small intestine) to provide enteral nutrition directly. This is typically done during another surgical operation.

Purpose

Medical Condition or Problem Addressed:
Patients who cannot eat by mouth, have obstructions, or need bypass of the upper gastrointestinal tract.

Goals or Expected Outcomes:
To ensure nutritional support, bypass gastrointestinal obstructions, or provide a means for postoperative feeding.

Indications

Specific Symptoms or Conditions:

• Severe swallowing difficulties (dysphagia)
• Gastrointestinal obstructions
• Certain cancers
• Postoperative nutrition support

Patient Criteria or Factors:

• Inability to ingest food orally
• Need for long-term enteral nutrition
• Patients undergoing major gastrointestinal surgery

Preparation

Pre-Procedure Instructions:

• Fasting for at least 8 hours prior
• Adjustments to medications as advised by the healthcare provider

Diagnostic Tests or Assessments:

• Blood tests
• Imaging studies like X-rays or CT scans
• Nutritional assessments

Procedure Description

Step-by-Step Explanation:

1. The patient is placed under general anesthesia.
2. A small incision is made in the abdomen.
3. A tube or needle catheter is inserted into the jejunum.
4. The tube is secured in place and connected to the exterior for feeding.
5. The incision is closed and secured with sutures or staples.

Tools and Equipment:

• Surgical instruments
• Jejunostomy tube or needle catheter
• Anesthesia delivery systems

Anesthesia or Sedation Details:

• General anesthesia is commonly used for patient comfort and immobility.

Duration

The procedure typically takes about 1 to 2 hours, depending on complexity.

Setting

This procedure is performed in a hospital operating room.

Personnel

• Surgeons
• Anesthesiologists
• Surgical nurses
• Operating room technicians

Risks and Complications

Common Risks:

• Infection at the incision site
• Bleeding

Rare Risks:

• Injury to surrounding organs
• Tube dislodgement or blockage
• Peritonitis (inflammation of the abdominal lining)

Complications Management:

• Monitoring for signs of infection or complications
• Immediate medical intervention if complications are suspected

Benefits

Expected Benefits:

• Direct nutritional support
• Improved recovery and nutritional status
• Bypass of obstructed or dysfunctional gastrointestinal sections

Realization of Benefits:

• Benefits are usually seen immediately post-surgery once feeding begins.

Recovery

Post-Procedure Care:

• Monitoring in a hospital setting
• Instructions on tube care and feeding protocols
• Pain management

Expected Recovery Time:

• Initial recovery within a few days
• Full recovery in a couple of weeks

Restrictions and Follow-up:

• Limited physical activity during initial recovery
• Regular follow-up to monitor tube function and nutritional status

Alternatives

Other Treatment Options:

• Nasogastric (NG) tube feeding
• Percutaneous endoscopic gastrostomy (PEG)
• Total parenteral nutrition (TPN)

Pros and Cons of Alternatives:

• NG tubes are less invasive but not suitable for long-term use.
• PEGs are less invasive but may not bypass all upper GI tract issues.
• TPN avoids the GI tract but carries risks of infection and metabolic complications.

Patient Experience

During the Procedure:

• The patient will be under general anesthesia and will not feel the procedure.

After the Procedure:

• Mild to moderate pain at the incision site managed by prescribed pain medications.
• Initial discomfort adjusting to the jejunostomy tube.

Pain Management and Comfort Measures:

• Use of pain relief medications
• Instructions on positioning to reduce discomfort and proper tube care to avoid irritation