Purpose Buried bumper (BB) is a rare complication of percutaneous endoscopic gastrostomy (PEG). The minimal incision endoscopic PEG pull through (MIEPT) technique and outcome are reported.Methods All BB managed in January 2011-May 2021 were included. Under endoscopic vision, the PEG tube with BB is cut to facilitate passage of a guide-string into the stomach and brought out through the oral cavity. The tapered end of a new PEG tube is tied to the string and pulled back into the stomach against the flange of the original PEG. A minimal incision is made at skin and fascia levels to facilitate pull-through of both tubes using the original track, without mucosal disruption. The incision is sutured.Results Eight patients had BB treated with MIEPT at median age of 13 years (5-16). Median time from insertion to BB developing was 26 months (18-41). Follow-up was 36 months (3-39): time to full gastrostomy feed was 12 h (12-24) and time to discharge was 48 h (24-48 h). Recurrence of BB occurred in two. None had early postoperative complication. Conclusion MIEPT is an effective minimally invasive technique in children to avoid a laparotomy for BB, with the advantage of complete mucosal preservation which prevents leakage.Heading Percutaneous endoscopic gastrostomy (PEG) , Buried bumper , Complication , Minimally invasive , Incision , Pull-through
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