Laparoscopic Repair of a Duodenal Atresia and Ladd’s Procedure in a Neonate with Malrotation

From the APSA 2011 Annual Meeting proceedings

LAPAROSCOPIC REPAIR OF A DUODENAL ATRESIA AND LADDâS PROCE DURE IN A NEONATE WITH MALROTATION

Author:

Steven S. Rothenberg
The Rocky Mountain Hospital For Children, Denver, CO, USA

Purpose
To demonstrate current refinements of technique in performing a duodenal anastomosis in a neonate with duodenal atresia. This work is IRB exempt.

Methods
A 33 week premature infant with a prenatal diagnosis of Duodenal atresia was explored laparoscopically on day two of life for repair. The patients weight was 2 Kg. Two 3mm ports and one 4mm port were used for the procedure. The patient was also found to have malrotation at the time of surgery. The procedure consisted of a Laddâs procedure and duodenoduodenostomy. Techniques of abdominal wall retraction sutures are demonstrated.

Results
The procedure was completed successfully laparoscopically. The procedure took 60 minutes. An NG tube was used for 5 days and feeds were started on post-op day 6.

Conclusions
This video demonstrates that a laparoscopic duodenoduodenostomy and Laddâs procedure is efficacious and safe even in a small premature.