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Laparoscopic-guided gastropexy for intermittent gastric volvulus
1Department of Pediatric General Surgery, British Columbia's Children's Hospital, Vancouver, Canada.
Journal of Pediatric Surgery
|December 1, 1993
Summary
A minimally invasive gastropexy using percutaneous sutures and laparoscopic guidance prevented gastric volvulus recurrence in a pediatric patient. This technique is suitable for children with intermittent gastric volvulus without other underlying abnormalities.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- Gastric volvulus is a rare but serious condition in children.
- Severe scoliosis and neurological impairment can be associated with gastric volvulus.
- Nasogastric tube decompression provides initial management but recurrence is common.
Observation:
- A 12-year-old girl with acute gastric volvulus, severe scoliosis, and neurological impairment was initially managed with nasogastric tube decompression.
- To prevent recurrence, an anterior gastropexy was performed using percutaneous sutures with endoscopic and laparoscopic guidance.
- The stomach was secured in a non-rotated position.
Findings:
- The described gastropexy technique successfully prevented recurrence of gastric volvulus one year post-procedure.
- The procedure was performed with the gastroscope in place and laparoscopic assistance.
Implications:
- This minimally invasive anterior gastropexy is a viable option for managing intermittent gastric volvulus in children.
- The technique is specifically indicated for patients without underlying abnormalities like diaphragmatic hernia.
- Laparoscopic guidance ensures accurate placement and fixation of the stomach, reducing recurrence risk.