Development of a Modified Duodenum Traction Technique in Laparoscopic Duodenal Web Excision

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Duodenal webs are congenital obstructions requiring surgical intervention.
• Laparoscopic duodenal web resection is a safe and effective treatment for neonates.
• Optimal surgical exposure is crucial for successful laparoscopic duodenal web excision.

Purpose of the Study:

• To present a modified duodenal traction technique for laparoscopic duodenal web resection.
• To evaluate the feasibility and effectiveness of this modified technique in improving operative field exposure.
• To assess perioperative outcomes and short-term follow-up in neonates undergoing this procedure.

Main Methods:

• A modified duodenal traction technique using a 5-0 PDS-II suture was employed in 54 neonates.
• The suture was percutaneously inserted to retract the duodenum, enhancing exposure during laparoscopic surgery.
• Perioperative data and short-term follow-up data were retrospectively reviewed.

Main Results:

• All 54 procedures were successfully completed laparoscopically without conversion to open surgery or additional ports.
• The mean operative time for the traction technique was 336 seconds, with a mean total surgery duration of 77 minutes.
• No postoperative complications related to the traction technique were reported, with a mean hospital stay of 16 days.

Conclusions:

• The modified duodenal traction technique is a feasible and ideal method for improving operative field exposure in laparoscopic duodenal web resection.
• This technique enhances safety and efficiency in neonatal laparoscopic surgery for duodenal webs.
• The study demonstrates successful application and positive outcomes in a cohort of 54 neonates.