Laparoscopic Management of Uncomplicated Intestinal Malrotation in Children
Keywords:malrotation, midgut, laparoscopy, volvulus, Ladds procedure
Introduction: Anomalies of midgut rotation and fixation associated with volvulus and vascular compromise require urgent surgical intervention. Recent literature supports laparoscopic management of intestinal malrotation in children. But conversion and complication rates of laparoscopic treatment are higher, especially in neonates, and when associated volvulus and bowel ischemia are present. The authors present their experience and results of laparoscopic management of uncomplicated cases of intestinal malrotation in children excluding newborns.
Methods: A retrospective analysis of all the children who underwent elective laparoscopic Ladds (LL) procedure was done. All neonates and children presenting with signs of acute volvulus and bowel ischemia were excluded from LL procedure. Between April 2007 and April 2013, 12 patients underwent LL procedure at the authors institution. Of the 12 patients, 8 were boys and the age ranged from 3 months to 9 years. All patients were presented with symptoms of abdominal pain and intermittent bilious vomiting. Diagnosis of intestinal malrotation was suggested either by Doppler ultrasonography or upper gastrointestinal contrast study and confirmed by diagnostic laparoscopy in all the patients. A standard Ladds procedure with appendectomy was performed laparoscopically in all cases.
Results: All procedures were completed laparoscopically. Average duration of procedure was about 95 min (75130 min). Feeding was started on post-op day 1 and all patients were discharged by day 4. There were no immediate or early postoperative complications, but one patient developed intestinal obstruction on follow-up and required intervention. All patients are doing well on latest follow-up.
Conclusion: LL procedure can be successfully performed in infants and children with uncomplicated cases of intestinal malrotation. Conversion rates are negligible and complications are minimal if strict selection criteria are followed.
Bangladesh Journal of Endosurgery Vol.1(3) September 2013: 1-5
How to Cite
Authors of articles published in BJE retain the copyright of their articles and are free to reproduce and disseminate their work. A Copyright and License Agreement signed and dated by the corresponding author on behalf of all authors must be submitted with each manuscript submission.
Copyright Agreement Form
Bangladesh Journal of Endosurgery (BJE) copyright and license agreement:
Title of the Article:
In submitting a research article ('article') to Bangladesh Journal of Endosurgery (BJE) I certify that:
1. I am authorized by my co-authors to enter into these arrangements.
2. I warrant, on behalf of myself and my co-authors, that:
- the article is original, has not been formally published in any other peer-reviewed journal, is not under consideration by any other journal and does not infringe any existing copyright or any other third party rights;
- I am/we are the sole author(s) of the article and have full authority to enter into this agreement and in granting rights to BJE are not in breach of any other obligation. If the law requires that the article be published in the public domain, I/we will notify BJE at the time of submission upon which clauses 3 through 6 inclusive do not apply;
- the article contains nothing that is unlawful, libellous, or which would, if published, constitute a breach of contract or of confidence or of commitment given to secrecy;
- I/we have taken due care to ensure the integrity of the article. To my/our - and currently accepted scientific - knowledge all statements contained in it purporting to be facts are true and any formula or instruction contained in the article will not, if followed accurately, cause any injury, illness or damage to the user.
And I agree to the following license agreement:
BJE Open Access license agreement
Brief summary of the agreement
Anyone is free:
- to copy, distribute, and display the work;
- to make derivative works;
- to make commercial use of the work;
Under the following conditions: Attribution
- the original author must be given credit;
- for any reuse or distribution, it must be made clear to others what the license terms of this work are;
- any of these conditions can be waived if the authors gives permission.
Statutory fair use and other rights are in no way affected by the above.
Full BJE Open Access license agreement
(Identical to the 'Creative Commons Attribution License')
Authors Full Name: