LAPAROSCOPIC ANASTOMOSIS IN THE ATRESIA OF SMALL BOWEL

Abstract

Introduction. A complete laparoscopic intestinal anastomosis remains a challenge for pediatric surgeons. The aim of the study is to demonstrate its effectiveness in patients with small bowel atresia. Material and methods. This article describes laparoscopic surgery in a patient with small bowel atresia of type I. During laparoscopy, stitches were placed on the blind end of the atresia segment of the intestine to stabilize the movable intestinal segment; the stitches were passed transdermally to the outside. The design of the laparoscopic anastomosis did not differ from that of the open technique proposed by Jannie Louw. At the final stage of the trial, the researchers assessed immediate and long-term results after this new surgical intervention. Results. Laparoscopic intervention for small bowel atresia of type I was performed on the second day of life. The surgery lasted for 75 minutes. No complications were registered during it. The enteral nutrition was started after the decrease in the rate of losses in the gastric tube lower than 10 ml / kg / day. It was on day 3 after the surgery. A gradual increase in the volume of feeding promoted patient’s transfer to the full enteral nutrition on day 7 after the surgery. Next day, the baby was discharged from the hospital. Early follow-up revealed no any signs of anastomosis failure. One-year follow-up revealed no signs of impaired intestinal transit too. Conclusion. It seems that the care of small bowel atresia has taken a significant step forward. Anastomoses constructed laparoscopically in such patients are not only a possible option, they have demonstrated their effectiveness and safety as well.