Laparoscopic treatment of intussusception

Abstract

Introduction: The success of laparoscopic approach in children has encouraged the application of this technique in young (<2 years) children with non-complicated intussusception.

Material and method: A retrospective analysis of our database provided a total of 4 patients who underwent laparoscopic reduction of intestinal intussusception between 8/2008 and 4/2013. A comprehensive review of each case was done including the video description of the laparoscopic technique of one of them.

Results: Four patients (2 boys) were treated by laparoscopy for intestinal intussusception. Mean age was 9 months (5-20 months). Delay time between initial symptoms and diagnosis and between diagnosis and surgery were 3.5 days and 6h respectively. Mean operative time was 35min. There were no conversions. There were no complications. Patients were discharged after 2.5 days (2-4 days). We herein report (video) the laparoscopic approach in a 5 month male child who suffered from a ileocecal intussusception. A 10mm trocar was placed in the left lower quadrant and two 5mm trocars were placed in the upper left quadrant and suprapubic just to the right midline. The cause of the intussusception was identified and the bowel was reduced. A concomitant appendectomy was performed.

Conclusion: Laparoscopic reduction of intussusception appears to be a safe procedure, in young children with uncomplicated intussusception.

Keywords: Intussusception; Laparoscopic; Treatment.

Fig. 1

Fig 1-A: Image showing trocar placement (10 mm trocar was placed in the lower inferior quadrant, a 5 mm trocar in the left upper quadrant and finally a 5 mm trocar in the suprapubic area). Fig 1-B. Ileocolic intussusception Fig 1-C. Reduction of the intussusception completed by a combination of delicate direct pressure on the transverse colon and gentle pulling on the distal small bowel. Fig 1-D: An appendectomy was performed.