After exposure of the anterior wall of the stomach by clamps, a purse-string suture is prepared. In the center of this suture line, the gastric wall is incised. If necessary, the incision is dilated gently and the tube is introduced into the gastric lumen (A).
In cases of caustic burns, antral and pyloric irregularities should be excluded by intragastric digital palpation of the poststomal stomach. After proper positioning of the catheter, the purse-string is tied. Sufficiency of the suture line is tested by a filling test. Pulling the catheter to the abdominal wall should not result in ischemia of the peris-tomal stomach.
Optionally, about four seromuscular interrupted stitches may be appropriate for protection from secondary insufficiency of the purse-string suture, notably when greater amounts of ascites are present (B).
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