Laparoscopic percutaneous endoscopic gastrostomy removal in a patient with buried-bumper syndrome - A new approach

Buried bumper syndrome is an uncommon long-term complication of gastrostomy tubes. The overgrowth of the gastric mucosa over the internal bumper of the tube often is symptomatic and leads to mechanical failure of feed delivery and peritubal discharge. Whilst removal of the buried internal bumper has been accomplished endoscopically in some cases, it is traditionally removed at laparotomy. This is the first description, however, of a successful laparoscopic removal of a percutaneous endoscopic gastrostomy tube in a patient with a buried bumper syndrome. The patient made an uneventful recovery and was discharged home on the third postoperative day. The operative technique is described, and its merits are discussed.