Open Gastrostomy (Stamm)

1.Short upper midline incision
2.Choose area of mid-stomach, closer to greater curve and place a pursestring suture of 2cm diameter using 3/0 PDS or prolene.
3.Grasp left side linea alba via incision using Morrisons forceps and make a stab wound through skin and middle third of rectus opposite pursestring in stomach wall.
4.Pass Fraser forceps from peritoneal side through stab wound and bring through a 18F Foley catheter.
5.Perform gastrotomy through previously placed pursestring and insert Foley into stomach, then tie the pursestring.
6.Place a second row of pursestring suture to invert first pursestring.
7.Inflate Foley balloon and draw up to anterior abdominal wall.
8.Place four sutures of prolene on four sides of Foley catheter between stomach and anterior abdominal wall.
9.Close abdomen in layers.
10.The gastrostomy can be used immediately.