Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Oct 16, 2022; 14(10): 616-627
Published online Oct 16, 2022. doi: 10.4253/wjge.v14.i10.616
Laparoscopic Janeway gastrostomy as preferred enteral access in specific patient populations: A systematic review and case series
Max Murray-Ramcharan, Maria Camilla Fonseca Mora, Federico Gattorno, Javier Andrade
Max Murray-Ramcharan, Department of General Surgery, Harlem Hospital Center, Harlem, NY 10037, United States
Maria Camilla Fonseca Mora, Department of Medicine, NYU Langone Medical Center-Woodhull Medical Center, Brooklyn, NY 11206, United States
Federico Gattorno, Javier Andrade, Department of Surgery, NYU Langone Medical Center-Woodhull Medical Center, Brooklyn, NY 11206, United States
Author contributions: Murray-Ramcharan M conceptualized research study and both Murray-Ramcharan M and Fonseca Mora M designed the research study; Murray-Ramcharan M and Fonseca Mora M performed the research; Gattorno F and Andrade J contributed analytic tools and editing; Murray-Ramcharan M and Fonseca Mora M analyzed the data and wrote the manuscript; all authors have read and approve the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Max Murray-Ramcharan, MD, Doctor, Department of General Surgery, Harlem Hospital Center, 506 Lenox Avenue, Harlem, NY 10037, United States.
Received: June 6, 2022
Peer-review started: June 6, 2022
First decision: August 1, 2022
Revised: August 5, 2022
Accepted: October 4, 2022
Article in press: October 4, 2022
Published online: October 16, 2022

Nutrition is one of the fundamental needs of both patient and non-patient populations. General trends promote enteral feeding as a superior route, with the most common enteral access being the percutaneous endoscopic gastrostomy (PEG) as the first-line procedure, with surgical access including Witzel gastrostomy, Stamm Gastrostomy, Janeway gastrostomy (JG) as secondary means.


To describe cases and technique of laparoscopic Janeway gastrostomy (LJG) and perform a systematic review of the data.


We successfully performed two LJG procedures, after which we conducted a literature review of all documented cases of LJG from 1991 to 2022. We surveyed these cases to show the efficacy of LJG and provide comparisons to other existing procedures with primary outcomes of operative time, complications, duration of gastrostomy use, and application settings. The data were then extracted and assessed on the basis of the Reference Citation Analysis (


We presented two cases of LJG, detailing the simplicity and benefits of this technique. We subsequently identified 26 articles and 56 cases of LJG and extrapolated the data relating to our outcome measures. We could show the potential of LJG as a viable and preferred option in certain patient populations requiring enteral access, drawing reference to its favorable outcome profile and low complication rate.


The LJG is a simple, reproducible procedure with a favorable complication profile. By its technical ease and benefits relating to the gastric tube formed, we propose this procedure as a viable, favorable enteral access in patients with the need for permanent or palliative gastrostomy, those with neurologic disease, agitation or at high risk of gastrostomy dislodgement, or where PEG may be infeasible.

Keywords: Laparoscopic Janeway gastrostomy, Janeway, Nutrition, Feeding tube, Enteral access, Reproducible

Core Tip: This systematic review identifies that the laparoscopic Janeway gastrostomy may be advantageous as a first line option for enteral access in specific patient populations, when compared to percutaneous endoscopic gastrostomy, or other surgical gastrostomy options, by virtue of the gastric tube created and its resistance to dislodgment and ensuing complications. Patients with high risk for tube dislodgment, including those with neurocognitive disorders, seizures, dementia, or patients requiring permanent enteral feeding access, may benefit the most from this intervention as a first-line option.