摘要
Purpose The aim of this study was to describe a new technique for the surgical management of prenatally diagnosed small bowel atresia. Methods Under general a nesthesia, a 5-mm trocar was inserted using an open technique through an intrau mbilical incision. The proximal atretic bowel end was identified using laparosco py and mobilized toward the umbilicus using an additional 3-mm trocar inserted in the left lower quadrant. The umbilical trocar then was removed, and a ring re tractor was inserted into the trocar site and used to expand the wound to delive r both atretic bowel ends. The bowel was repaired and returned to the abdomen th rough the umbilical wound. The umbilical fascia and skin were closed conventiona lly. Results Three patients were reviewed. Two had minimal abdominal distension, and the atretic bowel ends could be identified easily; laparoscopy-assisted su rgery was successful. The third case had significant dilatation, and laparotomy was required. Postoperatively, there was minimal abdominal scarring, and the umb ilicus was normal in appearance. Conclusions Although this experience is limited to 3 patients, this technique is simple, safe, and virtually scar free and can be applied for the treatment of neonates with prenatally diagnosed small bowel a tresia, especially if there is minimal abdominal distension at birth.
Purpose The aim of this study was to describe a new technique for the surgical management of prenatally diagnosed small bowel atresia. Methods Under general a nesthesia, a 5-mm trocar was inserted using an open technique through an intrau mbilical incision. The proximal atretic bowel end was identified using laparosco py and mobilized toward the umbilicus using an additional 3-mm trocar inserted in the left lower quadrant. The umbilical trocar then was removed, and a ring re tractor was inserted into the trocar site and used to expand the wound to delive r both atretic bowel ends. The bowel was repaired and returned to the abdomen th rough the umbilical wound. The umbilical fascia and skin were closed conventiona lly. Results Three patients were reviewed. Two had minimal abdominal distension, and the atretic bowel ends could be identified easily; laparoscopy-assisted su rgery was successful. The third case had significant dilatation, and laparotomy was required. Postoperatively, there was minimal abdominal scarring, and the umb ilicus was normal in appearance. Conclusions Although this experience is limited to 3 patients, this technique is simple, safe, and virtually scar free and can be applied for the treatment of neonates with prenatally diagnosed small bowel a tresia, especially if there is minimal abdominal distension at birth.
