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Published on: September 11, 2021
Laparoscopic intervention for intrathoracic stomach in infants
1Department of Surgery II, Kinki University, School of Medicine, 377-2 Ohno-Higashi, Osaka-Sayama, 589-8511, Japan. yagim@med.kindai.ac.jp
Insights
Laparoscopic repair of intrathoracic stomach in infants is safe and effective. This minimally invasive approach successfully treated four infants with no adverse complications or recurrence.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
Background:
- Intrathoracic stomach, a rare condition in infants, presents unique surgical challenges.
- Successful management of intrathoracic stomach in pediatric patients is crucial for long-term outcomes.
Observation:
- Four infant cases of intrathoracic stomach were successfully managed using laparoscopic techniques.
- The surgical procedure involved repositioning the stomach, resecting the phrenoesophageal ligament, narrowing the hiatus, and performing a floppy fundoplication.
Findings:
- Laparoscopic repair resulted in no adverse complications in any of the patients.
- Excellent cosmetic outcomes were achieved in all cases.
- No symptomatic gastroesophageal reflux or radiographic hernia recurrence was observed post-operatively.
Implications:
- Laparoscopic repair of intrathoracic stomach is a safe and feasible option for pediatric surgeons.
- Adequate preoperative evaluation is essential for successful laparoscopic management of intrathoracic stomach.
- Minimally invasive surgery offers excellent cosmesis and functional outcomes for infants with intrathoracic stomach.
Background:
Intrathoracic stomach is an uncommon condition in infants. We report our experience managing such a condition successfully by laparoscopy in four patients.
Methods:
Patients' ages at the time of operation ranged from 30 days to 14 months. In all cases, the intrathoracic stomach was easily pulled down into the abdominal cavity. The phrenoesophageal ligament was completely resected, and the enlarged hiatus was narrowed by intraabdominal suturing technique. The esophagus was wrapped with the mobilized fundus in a floppy fundoplication. Anchoring sutures were placed between the wrapping cuff and crura.
Result:
One patient had paraesophageal hernia (type 2), whereas the other had combined hiatal hernia (type 3). No adverse complications were observed in any of the cases. Symptomatic gastroesophageal reflux and radiographic recurrence of hernia were not seen in any case. The cosmesis was excellent in all cases.
Conclusions:
We conclude that laparoscopic repair for intrathoracic stomach is a safe and feasible method when preoperative evaluation is conducted adequately.
