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. 2016 Nov;98(8):578-580.
doi: 10.1308/rcsann.2016.0218. Epub 2016 Sep 22.

Laparoscopic repair of congenital duodenal obstruction is feasible even in small-volume centres

B J MacCormack  1 , Jph Lam  1
Affiliations

Laparoscopic repair of congenital duodenal obstruction is feasible even in small-volume centres

B J MacCormack et al. Ann R Coll Surg Engl. 2016 Nov.

Abstract

INTRODUCTION It has been suggested that laparoscopic repair of congenital duodenal obstruction (CDO) should be restricted to a limited number of designated centres of expertise. After gaining extensive experience with intracorporeal suturing in other procedures, we evaluated the feasibility of this approach at the Royal Hospital for Sick Children (RHFSC; Edinburgh, UK). METHODS We conducted a retrospective review of all cases of CDO presenting to the RHFSC from 2012 to 2014. Cases were identified from our electronic database using standardised codes. Data comprised: gestation; birth weight; associated anomalies; patient age and weight at surgery; operative time; complications; postoperative course. RESULTS Five consecutive non-selected cases of isolated CDO were repaired laparoscopically, and all were carried out by the senior surgeon. The male:female ratio was 4:1. Corrected gestational age at surgery was 35-38 weeks, and the weight at surgery was 1.7-3.1 kg. None of our patients had significant associated anomalies. CONCLUSIONS The present study demonstrates the feasibility of laparoscopic repair of CDO in small-volume centres, and is the first report of laparoscopically managed congenital duodenal atresia in twins.

Keywords: Congenital duodenal obstruction; Dizygotic male twins; Double bubble; Small-volume centre.

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Figures

Figure 1
Figure 1
View of the anastomotic setup showing: A, suspension suture in the dilated first part of the duodenum; B, luminal view of completed posterior wall of the anastomosis; C, a 10cm segment of a nasogastric tube (used to probe distally); D, collapsed third part of the duodenum.
See this image and copyright information in PMC

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