Transumbilical Single-incision Laparoscopic Assisted Surgery for Neonatal Congenital Intestinal Atresia / 中国微创外科杂志

ABSTRACT

Objective To discuss the efficacy of transumbilical single-incision laparoscopic surgery for neonatal congenital intestinal atresia.Methods A retrospective analysis was conducted on data of 27 children admitted to our hospital from September 2019 to September 2022 who underwent transumbilical single-incision laparoscopic assisted surgery.A curved incision on the right side of the umbilicus to 1/2 circumference was made.A 3.5 cm disposable single hole multi-channel port(Port)was inserted.The intestinal atresia was located under direct vision.The proximal hypertrophic intestinal tube was removed,and the distal intestinal tube to the mesenteric side was cut open.Intermittent single layer suture with 5-0 absorbable suture was performed for end-oblique incision anastomosis.Then the CO2 pneumoperitoneum was established,and the entire abdominal cavity was observed to deal with combined deformities.Results The surgery was successfully completed in all the 27 patients,without conversion to open surgery.During the surgery,15 cases of jejunal atresia and 12 cases of ileal atresia were confirmed.There were 8 cases of type Ⅰ,5 cases of type Ⅱ,12 cases of type Ⅲa,and 2 cases of type Ⅲb.During the surgery,there were 5 cases of meconium peritonitis,1 case of biliary atresia,2 cases of intestinal malrotation,1 case of Meckel's diverticulum,2 cases of cryptorchidism,and 1 case of inguinal hernia.The median surgical time was 110.0(90.0,122.5)min.The median postoperative feeding time was 11.0(7.0,14.5)d.No anastomotic leakage occurred.The median postoperative hospital stay was 18.0(15.0,33.5)d.One child underwent the second surgery.A total of 22 cases were followed up for 0.5-4 years(average,2.3 years)without re-operations.Conclusions Transumbilical single-incision laparoscopic surgery for neonatal congenital intestinal atresia is scarless and easy to operate.Combined with the use of a Port,it can reduce intestinal compression and facilitate traction.Laparoscopy can simultaneously handle combined deformities.