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Laparoscopic Ladd'S Procedure in Children: Challenges, Results, and Problems.
A Suyodhan Reddy1, Rasik S Shah1,2, Dattaguru R Kulkarni1
1Department of Pediatric Surgery, Grant Medical College and Sir J.J. Hospital, Mumbai, Maharashtra, India.
Journal of Indian Association of Pediatric Surgeons
|April 24, 2018
Summary
Laparoscopic Ladd's procedure is a feasible option for treating intestinal malrotation in children, though some cases require conversion to open surgery or reoperation for symptom recurrence.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Intestinal malrotation in children presents surgical challenges.
- Laparoscopic correction of malrotation requires careful consideration of indications, outcomes, and potential complications.
Purpose of the Study:
- To review the authors' experience with laparoscopic correction of intestinal malrotation in pediatric patients.
- To evaluate the feasibility, success rates, and complications associated with the laparoscopic Ladd's procedure.
Main Methods:
- A retrospective analysis of 41 pediatric cases diagnosed with intestinal malrotation.
- Evaluation based on clinical and radiological findings.
Main Results:
- Successful laparoscopic Ladd's procedure in 35 cases, with 6 conversions to open surgery.
- Average hospital stay of 4 days and restoration of feeding by day 3.
- Nine cases experienced symptom recurrence, necessitating open surgery for re-intervention.
Conclusions:
- Laparoscopic Ladd's procedure is feasible for pediatric intestinal malrotation, with or without volvulus.
- Conversion to open surgery may be necessary due to anatomical challenges.
- Recurrent symptoms require reoperation, often due to incomplete correction or adhesions.