Surgery for suspected rotation abnormality: selection of open vs laparoscopic surgery using a rational approach

Asymptomatic malrotation: Diagnosis and surgical management

“…The largest series of laparoscopic treatment of malrotation to date came from Hsiao and Langer in Toronto, who reported on a series of 51 patients who underwent laparoscopic Ladd operations out of 173 total malrotation procedures over a 10 year period [33]. A majority of the laparoscopic cases were in nonneonates (n = 45), and there was an overall 22% conversion rate to open procedure.…”

Minimal invasive surgery in the newborn: Current status and evidence

“…[54][55][56] At that time some surgeons restricted the role of laparoscopy to cases without midgut volvulus. 54,[57][58][59][60] Those authors felt that a complete overview on the bowel by "spreading out" the intestinal tract was not possible and therefore this technique was inadequate compared to the traditional open approach. However, in the last decade, several other groups successfully applied laparoscopic techniques in patients with midgut volvulus, even when signs of intestinal ischemia were present.…”

Is Screening of Intestinal Foregut Anatomy in Heterotaxy Patients Really Necessary?

“…Neonatal laparoscopy in suspected IRA can be challenging because of the limited domain and difficulty in identifying anatomy. 38 In heterotaxy, these problems may be magnified by the unusual spectrum of IRA seen, as well as abnormally sited and sized abdominal viscera, including hepatosplenomegaly associated with cardiac anomalies. Furthermore, the pneumoperitoneum may have adverse effects on cardiorespiratory physiology 39 in a patient cohort with limited reserve.…”

“…40 There are now numerous published studies recommending laparoscopic intervention, usually for nonneonatal and elective cases. 38 A recent study by the American Pediatric Surgical Association outcomes and evidence-based practice committee 41 made effort(s) to FIGURE 1. The outcome of MINORS scoring to assess quality of studies included within the systematic review.…”