Acta Medica Mediterranea, 2014, 30: 1175 LETTER TO THE EDITOR PERCUTANEOUS GASTROSTOMY PERFORMED WITH A MAGNETIC TIPPED NASOGASTRIC TUBE Ibrahim UYGUN, MD, Associate Professor Department of Pediatric Surgery and Pediatric Urology, Dicle University Medical Faculty, 21280 Diyarbakir, Turkey Dear Sir, Magnets have been used increasingly to treat various diseases such as biliary duct strictures, malignant gastrointestinal obstruction, pectus excavatum, and esophageal atresia(1-5). We congratulate Akkaya et al., who described the performance of percutaneous gastrostomy in the rat using a reconfigured magnetic tipped nasogastric tube as a new method involving minimal incisions(1). Magnetic compression ostomies (gastrostomy, colostomy, and cystostomy) were first described in our studies(2-4). Gastrostomy requires general or local anesthesia, special equipment, and X-ray exposure when using the fluoroscopic technique. It is also associated with major and minor complications and high mortality rates(2). In our and Akkaya et al.’s small studies, the magnetic gastrostomy technique did not require expensive equipment, and no complications were observed in any of the rats(1,2). The magnetic insertion catheter was first specially designed by us. Its use involves the insertion of two small cylindrical magnets (outer diameter, 2 mm; thickness, 1 mm) into an 8-F truncated feeding tube(2,3). Although Akkaya et al. reconfigured this catheter with a 6-F nasogastric tube by attaching a longer magnet (2 × 5 mm) to the tip, they did not mention from where the reconfiguration was performed. Their magnetic tube size must have been 8-F, not 6-F, as shown by the blue nasogastric tube in Figure 1a and the mismatching of the outer diameter of the attached magnet with the tube size. They specified that an 8-F Foley catheter was inserted for the gastrostomy. The rats were fed an enteral feeding solution via the gastrostomy for 2 days. However, we think that an 8-F Foley balloon catheter is too large for a gastrostomy in a rat and that monitoring complications for only 2 days is not enough time to allow for wound healing. We wonder how the authors maintained the Foley catheter and fed the rats via the catheter. Akkaya et al.’s article is almost identical to our magnetic gastrostomy study(2). However, we congratulate them for addressing magnetic ostomy techniques. Magnetic gastrostomy techniques are easy to perform in rats and may be a simple alternative to some gastrostomy techniques used in humans. Conversely, further studies are required to develop magnetic ostomy techniques in large animals and humans. Received September 04, 2014; Accepted September 20, 2014 1) 2) 3) 4) 5) References Akkaya A, Sit M, Demirhan A, Bilgi M, Tekelioglu UY, Kocoglu H, Tekce H. Percutaneous gastrostomy performed with magnetic tipped nasogastric tube: a new method. Acta Medica Mediterranea 2014; 30: 319-22. Uygun I, Okur MH, Cimen H, Keles A, Yalcin O, Ozturk H, Otcu S. Magnetic compression gastrostomy in the rat. Pediatr Surg Int 2012; 28: 529-32. Uygun I, Okur MH, Arayici Y, Keles A, Ozturk H, Otcu S. Magnetic compression ostomy for simple tube colostomy in rats-magnacolostomy. Adv Clin Exp Med 2012; 21: 301-5. Uygun I, Okur MH, Cimen H, Keles A, Yalcin O, Ozturk H, Otcu S. Magnetic compression ostomy as new cystostomy technique in the rat: magnacystostomy. Urology 2012; 79: 738-42. Harrison MR: What if? Why not? J Pediatr Surg 2010; 45: 1-10. Ibrahim UYGUN, MD, Associate Professor Department of Pediatric Surgery and Pediatric Urology, Dicle University Medical Faculty 21280 Diyarbakir (Turkey)