The Cambridge experience with buried bumpers.


AIM:Buried Bumper (BB) is a complication of percutaneous endoscopic gastrostomy (PEG) that leads to tube dysfunction and major morbidity. Although many techniques have been described to manage BB, none are universally adopted, and laparotomy remains the mainstay. We introduce a novel endoscopic technique in paediatric surgery that avoids laparotomy. METHODS:A retrospective review of medical records of patients who presented with BB to Cambridge University Hospital, UK, between January 2012 and June 2018 was done. Data collected included: demographics, tube size and type, interval between insertion and diagnosis of BB, hospital stay, technique used, and postoperative complications. The technique involved using an endoscopic snare passed from inside the stomach lumen through the PEG lumen to the outside, guided if required by a stiff nylon thread if no part of the PEG was visible, grasping the PEG tube externally after cutting it short, followed by a retrograde pull to remove the buried tube via the mouth. MAIN RESULTS:Fifteen BBs were found in ten patients. Median patient age was 5.25 years (1.2-16.6). Median time between gastrostomy insertion and diagnosis of BB was 9 months (1-32). Twelve BBs were removed endoscopically with no postoperative complications. Patients had a replacement inserted through the original track and were discharged within 24 h. Two underwent laparotomies performed by surgeons unfamiliar with endoscopic technique, and one was converted to laparotomy owing to inability to transverse an encrusted and closed PEG tube lumen. CONCLUSION:Endoscopic retrograde BB removal is a safe, easy, and quick technique with minimal complications. We strongly advocate widespread adoption of the technique before considering a laparotomy. LEVEL OF EVIDENCE:Treatment study: Level IV.


J Pediatr Surg


Goneidy A,Malakounides G,Aslam A




Has Abstract


2019-02-01 00:00:00














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    abstract::The location anomaly of the verumontanum has not been described in the literature. We confirmed that the verumontanum was located either in the sphincteric or bulbous urethra in 61 of 477 patients with hypospadias (12.8%) through endoscopic examination and urethorgraphy. There was a patient with bilateral cryptorchidi...

    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Ikoma F,Shima H

    更新日期:1991-07-01 00:00:00

  • A case of intrapericardial diaphragmatic hernia with a massive pericardial effusion: fetal diagnosis and therapy.

    abstract::Intrapericardial diaphragmatic hernia is a very rare phenotype of neonatal diaphragmatic hernia which is thought to be caused by the developmental failure of the septum transversum. There have been only 10 cases reported since 1980, and among them, only 2 cases were diagnosed in fetal life. We herein report a new case...

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    authors: Kanamori Y,Hashizume K,Sugiyama M,Tomonaga T,Goishi K,Yokoyama Y,Igarashi T,Kikuchi A,Kawana Y,Kozuma S,Taketani Y

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    abstract:BACKGROUND:Single-incision laparoscopic surgery (SILS) has been successfully performed in children using 5-mm reticulating instruments. There are, however, few reports investigating the use of conventional instruments in SILS in the pediatric population. METHODS:We conducted a retrospective review of all consecutive c...

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    authors: Tam YH,Lee KH,Sihoe JD,Chan KW,Cheung ST,Pang KK

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    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章,评审


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    journal_title:Journal of pediatric surgery

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    journal_title:Journal of pediatric surgery

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    journal_title:Journal of pediatric surgery

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    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Overman RE Jr,Criss CN,Gadepalli SK

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  • Factors associated with pediatric firearm injury and enrollment in a violence intervention program.

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    journal_title:Journal of pediatric surgery

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    journal_title:Journal of pediatric surgery

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    journal_title:Journal of pediatric surgery

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    journal_title:Journal of pediatric surgery

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    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


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    更新日期:1992-03-01 00:00:00

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    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Pereira RM,Tatsuo ES,Simões e Silva AC,Guimarães JT,Paixão RM,Lanna JC,Miranda ME

    更新日期:2004-07-01 00:00:00

  • The impact of transfer on pediatric trauma outcomes.

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    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Locke T,Rekman J,Brennan M,Nasr A

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  • Management of bladder dysfunction in Wolfram syndrome with Mitrofanoff appendicovesicostomy: long-term follow-up.

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    pub_type: 杂志文章


    authors: Mozafarpour S,Kajbafzadeh AM,Mojtahed A,Mojtahed M,Mahboubi H,Shalileh K

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  • Training general surgery residents in pediatric surgery: A Canadian survey.

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    journal_title:Journal of pediatric surgery

    pub_type: 杂志文章


    authors: Poenaru D,Fitzgerald P,Education Committee of the Canadian Association of Paediatric Surgeons.

    更新日期:2001-05-01 00:00:00