Laparoscopic Duodenoduodenostomy for Duodenal Atresia: Our Operative Technique

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  • 当科で経験した先天性十二指腸閉鎖症に対する腹腔鏡下ダイアモンド吻合術
  • 症例報告 当科で経験した先天性十二指腸閉鎖症に対する腹腔鏡下ダイアモンド吻合術
  • ショウレイ ホウコク トウ カ デ ケイケン シタ センテンセイ ジュウニシチョウ ヘイサショウ ニ タイスル フククウキョウ カ ダイアモンド フンゴウジュツ

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Abstract

We report mainly our operative laparoscopic duodenoduodenostomy technique for duodenal atresia (DA). A 1-day-old female infant 38 weeks and 2 days in gestation and 2,108 g in birth weight was diagnosed as having DA because abdominal X-ray showed a double bubble sign. She underwent laparoscopic surgery. The operator stood on the patient’s right side with the first assistant on the patient’s left side. After initial port insertion at the umbilical lesion, four additional ports were placed in the right and left upper quadrants and the right and left middle quadrants. We moved the intestine and the colon to the left side of the patient, and mobilized the duodenum by Kocher’s maneuver by dividing the lateral peritoneum. A transverse duodenostomy was performed in the proximal segment. The incision was 2 cm long and made 1 cm above the atresia. A longitudinal duodenostomy of the same length was created in the distal segment with L-shaped electrocautery. A diamond anastomosis was made with a single layer of interrupted sutures on the posterior wall and continuous sutures on the anterior wall. We could maintain a good exposure of the operative field. Laparoscopic surgery for DA in neonates was a safe and feasible procedure.

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