Laparoscopic management of duodenal atresia: a decade of single surgeon's perspective

This study aimed to evaluate the outcomes and learning curve of laparoscopic duodenal atresia repair performed by a single pediatric surgeon over 10 years and compare it with traditional open repair.

This retrospective study included 28 neonates who underwent surgical repair for congenital duodenal atresia between 2010 and 2024 at a tertiary center. In total, 20 patients underwent laparoscopic repair by a single surgeon between 2013 and 2024, whereas 8 underwent open repair between 2010 and 2014. Clinical characteristics, operative times, feeding milestones, and complications were compared. To assess the effect of surgical experience, the laparoscopic cohort was divided into early and late phases.

The median operative time was longer in the laparoscopic group than in the open group (124 minutes vs. 80 minutes, P < 0.05). However, laparoscopic patients achieved earlier oral intake (5 days vs. 9 days, P = 0.021) and full enteral feeding (8 days vs. 13 days, P = 0.028). No significant differences were observed in complication rates. The operative time improved significantly throughout the laparoscopic series, decreasing from 155 minutes in early cases to 110 minutes in later cases (P = 0.039). No conversions or anastomotic leaks were observed in the late laparoscopic group.

Laparoscopic duodenal atresia repair performed by a single surgeon is safe and effective, allowing for faster postoperative recovery than open repair. With accumulated experience, operative efficiency improves significantly, supporting its broader adoption in neonatal surgery.