Document Detail

Laparoscopic duodenoduodenostomy for duodenal atresia.
MedLine Citation:
PMID:  12200660     Owner:  NLM     Status:  MEDLINE    
A 3,220-g newborn baby with trisomy 21 presented with duodenal atresia. No other congenital malformations were diagnosed. Informed consent for a laparoscopic approach was obtained. The child was placed in a supine, head-up position slightly rotated to the left at the end of a shortened operating table. The surgeon stood at the bottom end with the cameraperson to his left and the scrub nurse to his right. The screen was at the right upper end. Open insertion of a cannula for a 5-mm 30 degrees telescope through the inferior umbilical fold was performed. A carbon dioxide (CO2) pneumoperitoneum with a pressure of 8 mmHg and a flow of 2l/min was established. Two 3.3-mm working cannulas were inserted; one in the left hypogastrium and one pararectally on the right at the umbilical level. Two more such cannulas were inserted; one under the xyphoid for a liver elevator and one in the right hypogastrium for a sucker. Mobilization of the dilated upper and collapsed lower duodenum was easy. After transverse enterotomy of the upper duodenum and longitudinal enterotomy of the distal duodenum, a diamond-shaped anastomosis with interrupted 5 zero Vicryl sutures were performed. The absence of air in the bowel beyond the atresia increased the working space and greatly facilitated the procedure. The technique proved to be easy, and the child did very well. Laparoscopic bowel anastomosis in newborn babies had not been described previously. Recently, a diamond-shaped duodenoduodenostomy for duodenal atresia was performed. The technique proved to be simple and is described in detail. The child did very well.
N M Bax; B M Ure; D C van der Zee; I van Tuijl
Publication Detail:
Type:  Case Reports; Journal Article     Date:  2000-12-21
Journal Detail:
Title:  Surgical endoscopy     Volume:  15     ISSN:  0930-2794     ISO Abbreviation:  Surg Endosc     Publication Date:  2001 Feb 
Date Detail:
Created Date:  2002-08-29     Completed Date:  2003-01-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8806653     Medline TA:  Surg Endosc     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  217     Citation Subset:  IM    
Department of Pediatric Surgery KE. 4. 140.05, Wilhelmina Children's Hospital, University Medical Center, P.O. Box 85090, 3508 AB Utrecht, The Netherlands. N.Bax@WKZ.AZU.NL
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MeSH Terms
Down Syndrome / complications
Duodenal Obstruction / complications,  congenital*,  surgery*
Duodenostomy / methods*
Infant, Newborn
Intestinal Atresia / complications,  surgery*
Laparoscopy / methods*

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