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Minimally invasive surgery in children with a history of congenital abdominal wall defects
1Division of Pediatric Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
Insights
Children with congenital abdominal wall defects (AWD) can safely undergo later laparoscopic surgeries. This study found laparoscopy feasible for these patients, suggesting AWD history isn't a contraindication.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Congenital Abnormalities
Background:
- Children with congenital abdominal wall defects (AWD) may require further abdominal surgery after initial defect closure.
- Evaluating surgical history and laparoscopic feasibility in this population is crucial.
Purpose of the Study:
- To assess the surgical history of patients with congenital abdominal wall defects (AWD).
- To determine the feasibility and safety of laparoscopic surgery in children with a history of AWD.
Main Methods:
- Retrospective review of patients treated for congenital AWD between 2000 and 2011.
- Comparison of subsequent abdominal surgical procedures for indication, technique, duration, blood loss, and hospital stay.
Main Results:
- 139 patients with AWD were identified; 30% (n=43) had subsequent surgeries (65 procedures total).
- Laparoscopic procedures accounted for 26% (n=17) of subsequent surgeries, with 2 conversions to open due to adhesions.
- No complications were reported from laparoscopic surgeries in this cohort.
Conclusions:
- Laparoscopic surgery is feasible and safe for many children with a history of congenital abdominal wall defects.
- A history of congenital AWD should not preclude consideration for laparoscopic interventions.
Purpose:
Children with a history of a congenital abdominal wall defect (AWD) occasionally require additional abdominal surgery later in life, after their defect is closed. In an effort to evaluate surgical history and assess the feasibility of laparoscopic surgery in this select patient population, a retrospective review was conducted looking at all patients treated with congenital AWD at a tertiary-care facility.
Patients And Methods:
Patients admitted between January 1, 2000 and January 1, 2011 with AWD were included in the study. Abdominal surgical procedures subsequent to closure of the defect were compared for indication, technique, length of surgery, estimated blood loss, and postoperative length of stay.
Results:
During the stated time period, there were 139 admissions with AWD (67 girls and 72 boys). Thirty percent of the children (n=43) underwent subsequent abdominal surgery after the closure of their defect for a total of 65 procedures. Seventy-four percent of these procedures (n=48) were performed by an open technique, and 26% were laparoscopic (n=17). Because of dense adhesive disease, 2 cases (12%) were converted from laparoscopic to open. There were no complications as a result of laparoscopic surgery in any of the patients.
Conclusions:
This study evaluates the surgical history of patients with AWDs after their defect is closed. The results of this study suggest that in many situations, laparoscopic surgery is feasible and can be safely conducted on children with a history of congenital AWD. Based on these results, a history of congenital AWD should not be considered a contraindication for laparoscopy.
