Laparoscopic versus Open Ladd’s Procedure for Intestinal Malrotation

Abstract

Background: Anomalous rotation and fixation of the intes-tines during fetal development leads to intestinal malrotation. Usually, it is characterized by intestinal volvulus, which might result in intestinal necrosis, and bilious vomiting. It has been estimated that 1 in 6000 live newborns have malrotation. Aim of Study: The aim of this study is to evaluate the lapa-roscopic versus open Ladd’s procedure for Intestinal Malrota-tion as regard operative details and postoperative outcome. Patients and Methods: This retrospective study included (57) patients who underwent definitive treatment for intestinal malrotation uncomplicated with volvulus at the pediatric sur-gery unit at Mansoura University Children Hospital, Egypt. during the period from October 2015 to September 2022. 30 patients were treated using laparoscopic Ladd’s technique and 27 patients were treated using open Ladd’s technique. Results: The children in the open operation group had a procedure lasting 83-115 minutes, whereas those in the lapa-roscopic group had one lasting 123-150 minutes. Although the laparoscopic group’s procedure took longer than the open group’s, it resulted in a shorter hospital stay and fewer inci-sional infections. Only laparoscopic procedures resulted in in-traoperative problems such as hemorrhage (3.3%) and intestinal damage (3.3%). Conclusion: We believe that laparoscopic Ladd’s procedure is a good choice for management of malrotation with uncom-plicated volvulus. The benefits of laparoscopic management of malrotation include a short hospital stay, rapid return of bowel function, minimal postoperative pain, and improved cosmosis.