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Laparoscopic fundoplication for a child with abdominal intrathecal Baclofen pump

Yuichi Okata1, Yuko Bitoh1, Yosuke Aida1

  • 1Division of Pediatric Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.

Asian Journal of Endoscopic Surgery
|August 21, 2019
PubMed

Insights

This case report details the first laparoscopic fundoplication in a child with an intrathecal Baclofen pump for cerebral palsy spasticity. The successful surgery resolved reflux and aspiration pneumonia, demonstrating a safe approach for complex pediatric cases.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Neurology

Background:

  • Severe spasticity due to cerebral palsy often necessitates intrathecal Baclofen pump (ITB) insertion.
  • Gastroesophageal reflux (GER) and aspiration pneumonia are common complications in these patients.
  • Previous management with gastrostomy and conservative therapy was unsuccessful.

Observation:

  • A pediatric patient with an ITB for cerebral palsy experienced persistent GER and aspiration pneumonia.
  • The presence of an ITB complicates abdominal surgery due to infection risks.
  • Laparoscopic fundoplication was considered as a treatment option.

Findings:

  • A successful laparoscopic fundoplication was performed in a child with an ITB.
  • No intraoperative complications occurred during the procedure.
  • The child remained asymptomatic with resolved GER and aspiration pneumonia at 18 months post-surgery.

Implications:

  • Laparoscopic fundoplication is a feasible and safe surgical option for GER in children with ITBs.
  • This approach can effectively manage refractory GER and aspiration pneumonia in complex pediatric cases.
  • Further studies may explore the long-term outcomes and safety of this combined treatment strategy.

Keywords:
fundoplicationgastroesophageal refluxintrathecal baclofen pump

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