142 Initial Experience with Laparoscopic AMT Capsule Monarch Feeding Tubes as a Long-Term Feeding Jejunostomy Conduit in Osophago-Gastric Cancer Patients

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Abstract Introduction The 9.6Fr Vygon Needle Catheter Jejunostomy (NCJ) has been the standard laparoscopic jejunostomy technique for Jejunal enteral nutrition at Mercy University Hospital in Cork, Ireland. Although effective for short-term enteral nutrition, its dependence on skin sutures is associated with significant complications in long-term use, including tube dislodgement, occlusion, and suture-site infections, often necessitating repeated intervention. Aim This study aimed to assess the safety, feasibility, and complication profile of the 12Fr Applied Medical Technology (AMT) Capsule Monarch gastrostomy tube—featuring an internal bolster and external T-bar, and sutureless fixation—when repurposed for long-term jejunostomy feeding Method Clinical outcomes for patients receiving AMT Capsule Monarch tubes (July 2024–January 2025) were prospectively collected and compared with retrospectively reviewed outcomes for Vygon NCJ tubes (January–June 2024), based on dietetic records. All patients had upper gastrointestinal malignancies requiring prolonged enteral support. Results Nineteen patients were included: ten received AMT Capsule Monarch tubes and nine received Vygon NCJs. Indications included neoadjuvant or definitive chemoradiotherapy, palliative care, and malnutrition following total gastrectomy. No perioperative complications were observed in either group. The Monarch tube group experienced fewer catheter-related complications, with no tube dislodgements or occlusions, and demonstrated reduced need for outpatient dressing interventions and emergency presentations compared to the Vygon cohort. Conclusions Laparoscopic insertion of the AMT Capsule Monarch tube offers a safe and effective alternative for long-term jejunostomy feeding. Its favourable complication profile supports its adoption as the preferred conduit for sustained enteral nutrition in patients with upper gastrointestinal malignancy.

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