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Single stage Percutaneous Rapid INsertion of a Gastrostomy button (SPRING) technique: A retrospective study in children

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Abstract

Purpose

Gastrostomy buttons are normally inserted in two stages. For children, both stages are performed under general anaesthetic (GA) in the UK. We report our 20 years experience of the SPRING technique. (Single stage, Percutaneous, Rapid INsertion of a Gastrostomy button).

Method

This paper retrospectively analysed case notes of all children who underwent a SPRING procedure between 1994 and 2014 in our institute. Patient details, success of placement, recovery process and early post-operative complications were recorded. A gastroscope is passed, and two Cope Gastrointestinal Anchor Sutures positioned. A dilator and splittable sheath are passed over a guide wire, the dilator is removed and a button inserted.

Results

300 patients underwent a GA for SPRING procedure.190 had a neurological diagnosis, 39 had Cystic Fibrosis, 16 had renal failure, and 55 had miscellaneous diagnoses. The age range was 3–238 months and their weights ranged from 3.0 to 128 kg. Of 300 attempts, 287 (95.6%) were successfully inserted. 12 required a 2.5 cm mini-laparotomy to identify the stomach and in one case the procedure was abandoned. Fourteen (4.9%) had a major complication requiring a 2nd GA and seventeen (5.9%) had minor surgical complications not requiring GA. The overall complication rate was 10.8%.

Conclusion

SPRING technique is a simple method for single stage gastrostomy button insertion with an acceptable complication rate.

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Funding

This Study did not get any funding.

Author information

Authors and Affiliations

  1. Department of Paediatric Surgery, University Hospital Southampton, Southampton, UK

    Ahmed A. Darwish, Philip Corbett, Ann Louson, Harriet Whewell & Mervyn Griffiths

  2. Department of Paediatric Surgery, Ain Shams University, Cairo, Egypt

    Ahmed A. Darwish

Authors
  1. Ahmed A. Darwish
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  2. Philip Corbett
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  3. Ann Louson
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  4. Harriet Whewell
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  5. Mervyn Griffiths
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Contributions

AD, PC, MG contributed to the conception and design of the research and drafting the manuscript; AD, HW critically revised the manuscript; AL contributed to the acquisition, analysis and interpretation of the data; and AD, PC drafted the manuscript. All authors critically revised the manuscript, agree to be fully accountable for ensuring the integrity and accuracy of the work, and read and approved the final manuscript.

Corresponding author

Correspondence to Ahmed A. Darwish.

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Conflict of interest

The authors report no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

For this retrospective study formal consent is not required.

Clinical relevancy statement

Gastrostomy buttons are normally inserted in two stages; both stages require general anaesthetics (GA). The SPRING technique (Single stage, Percutaneous, Rapid INsertion of a Gastrostomy button) permits a single stage insertion of gastrostomy button under a single GA.

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Darwish, A.A., Corbett, P., Louson, A. et al. Single stage Percutaneous Rapid INsertion of a Gastrostomy button (SPRING) technique: A retrospective study in children. J Ped Endosc Surg 2, 123–129 (2020). https://doi.org/10.1007/s42804-020-00064-8

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  • DOI: https://doi.org/10.1007/s42804-020-00064-8

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