Related Experiment Video

Updated: Jul 2, 2026

Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
07:36

Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery

Published on: February 10, 2023

Prophylactic appendectomy during Ladd's procedure: a multicenter survey of institutional approaches and their

Shojiro Hanaki1,2, Yudai Goto3,4, Keigo Yada3,5

  • 1Japanese Society of Pediatric Surgeons Under-45 Working Group, Tokyo, Japan. shojiro-hanaki@s.okayama-u.ac.jp.

Pediatric Surgery International
|February 9, 2026
PubMed

Insights

Japanese pediatric surgeons are divided on prophylactic appendectomy during Ladd's procedure for midgut volvulus. Decisions balance future diagnostic clarity against risks of unnecessary surgery.

Area of Science:

  • Pediatric Surgery
  • Surgical Procedures
  • Gastrointestinal Surgery

Background:

  • Ladd's procedure is a key surgical intervention for midgut volvulus.
  • The role of prophylactic appendectomy during Ladd's procedure remains debated.
  • Institutional practices vary regarding routine appendectomy in neonates.

Purpose of the Study:

  • To document Japanese institutional strategies for prophylactic appendectomy during Ladd's procedure.
  • To identify the rationales and exceptions guiding these surgical decisions.
  • To understand the current landscape of this surgical practice in Japan.

Main Methods:

  • A cross-sectional questionnaire survey was distributed to pediatric surgical institutions in Japan.
  • Institutions reported their approach to prophylactic appendectomy in a standardized scenario of emergency Ladd's procedure.
  • Responses from 45 institutions were analyzed descriptively.

Main Results:

  • Nearly half of responding institutions (48.9%) routinely perform prophylactic appendectomy during Ladd's procedure; 51.1% do not.
  • Reasons for performance include preventing future appendicitis and diagnostic confusion.
  • Reasons for non-performance focus on advanced imaging and avoiding unnecessary procedures.

Conclusions:

  • Japanese institutions exhibit standardized yet differing approaches to prophylactic appendectomy in Ladd's procedure.
  • These findings highlight the balance between diagnostic, operative, and reconstructive considerations.
  • Provides a basis for protocol refinement and outcome-based research in pediatric surgery.
Abstract

Keywords:
AppendectomyIntestinal malrotationLadd’s procedurePediatric surgeryQuestionnaire survey

More Related Videos

Laparoscopic Anatomical Hepatectomy Using Takasaki's Approach and Indocyanine Green Fluorescence Navigation05:27

Laparoscopic Anatomical Hepatectomy Using Takasaki's Approach and Indocyanine Green Fluorescence Navigation

Published on: May 16, 2025

Laparoscopic Radical Gastrectomy for Remnant Gastric Cancer05:30

Laparoscopic Radical Gastrectomy for Remnant Gastric Cancer

Published on: October 31, 2025

Related Concept Videos

Appendicitis-I: Introduction01:22

Appendicitis-I: Introduction

The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Appendicitis01:19

Appendicitis

Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...