Laparoscopy-assisted percutaneous endoscopic gastrostomy enables enteral nutrition even in patients with distorted anatomy

Figure 1 A 17-year-old patient with severe kyphoscoliosis (138 degrees on Cobb’s scale) with interposed organs.

Figure 2 Laparoscopy-assisted percutaneous endoscopic gastrostomy placement: An overview of the procedure. A: General view. The arrows indicate the following (respectively): liver, stomach and abdominal wall; B: Marking the puncture site. The arrows indicate the stomach and abdominal walls, and the pressed wall shows the puncture site; C: Introduction of the needle into the stomach under visual control. The arrows show the gastric wall and the trocar for percutaneous endoscopic gastrostomy (PEG) insertion; D: PEG was performed. The arrows indicate the gastric vessels and the trocar.