The gastrostomy tube was passed into the stomach and the balloon inflated. The inner purse string was tied to secure the tube and the second purse string was tied to invert the gastrostomy opening.
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The two ends of the purse string sutures with the needles still attached and two additional horizontal mattress sutures were used to seal the gastric serosa to the parietal peritoneum in four quadrants around the gastrostomy opening.
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