Laparoscopy in the Treatment of Children with Intussusception

Abstract

Intussusception is one of the main causes of intestinal obstruction in children that requires timely treatment. Despite the high efficacy of therapeutic methods of intussusception reduction, some patients need the surgery. The question of the surgery method choice, namely open laparotomy or laparoscopy, is still under debate.The objective of the research was to summarize own experience of laparoscopy in children with an intussusception.The research was grounded on the results of treatment of 28 children operated in the first surgical department of the Lviv Regional Children’s Clinical Hospital «OHMATDYT» during 2008-2015. Optical system Strayker 1088 HD (Germany) with the 3-, 5-mm laparoscopic equipment was used for laparoscopy. The reduction of intussusception was performed by the retrograde traction of small intestine with the sliding catches.Laparoscopic intussusception reduction was successful in 67.9% of patients, conversion was conducted in 32.1% of patients. The main reasons for the conversion were the necrosis of intestinal loop needing resection, presence of the complex intussusception, and the presence of polyp clear to the ileocecal valve. In 10.7% patients the laparoscopic reduction was supplemented by per rectum pneumoreduction with the help of Richardons’ system. During the last year, in cases of intestine resection need, the video-assisted operations were applied, when the intestine mobilization was performed laparoscopically and anastomosis was applied extraperitonealy. Complications during laparoscopic reduction and in the postoperative period were not observed.Laparoscopy is the safe and effective method of patients with the intussusception treatment. Thorough selection of patients for the laparoscopic intussusception reduction makes it possible to decrease the rate of conversion.