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Bowel Obstruction
Everything in the library about bowel obstruction — built automatically from the recorded discussions that name it
Educational content from recorded physician discussions — not medical advice. Always talk to your child's care team about your child's situation.
Content of this collection
Surgical Management
2 items
Laparoscopic Jejunal Atresia Repair - Technique
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Dr. Steven Rothenberg describes his technique for laparoscopic repair of jejunal atresia with apple peel defect. Key steps to the procedure include Veress entry, identification of the proximal and distal segments of jejunum, mobilization a
video5:55 · Nov 2018
Laparoscopic Jejunal Atresia Repair - Technique
Watch →
Dr. Steven Rothenberg describes his technique for laparoscopic repair of jejunal atresia with apple peel defect. Key steps to the procedure include Veress entry, identification of the proximal and distal segments of jejunum, mobilization a
video5:55 · Nov 2018
Evidence & Research
1 item
Dr. Alicia Greene - Best of the Best in Pediatric Surgery 2025
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Watch AAP's Dr. Alicia Greene’s presentation on “The Hidden Dangers: Superabsorbent Polymer Beads as an Increasing Cause of Bowel Obstruction in Children” at the 2025 Best of the Best in Pediatric Surgery event!
Moderators: Drs. Todd Pon
video7:42 · Mar 2025
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Every expert statement below comes from the recorded discussions, with its speaker and moment.
Laparoscopic Jejunal Atresia Repair - Technique
A newborn with prenatal diagnosis of bowel obstruction was found to have jejunal atresia on upper GI study
clinical0:00 ↗
The surgeon stands at the baby's feet with the cameraman on the baby's right and the scrub tech on the patient's left for this procedure
clinical0:30 ↗
A 3-port technique was used with a 4 mm 30-degree scope for visualization and two 3 mm ports for dissection
clinical0:50 ↗
The left mid-quadrant port was later changed to a 5 mm port for the stapler
clinical1:10 ↗
The Veress needle is inserted below the umbilicus to avoid injury to the umbilical vessels and prevent CO2 embolism
clinical1:20 ↗
There was a complete gap between the proximal jejunum and the distal bowel, with visualization of appendix and cecum suggesting an apple peel defect
clinical2:00 ↗
The bowel was run from proximal to distal to ensure there were no other areas of obstruction or kinking
clinical2:30 ↗
Running the bowel distally confirmed an apple peel defect, as the bowel could be seen twisting around the mesentery
clinical2:50 ↗
Because there was no evidence of a kink or significant obstruction, the mesentery was not further manipulated
clinical3:10 ↗
A decision was made to remove the proximal dilated segment in the hopes of improving bowel motility following surgery, because it was relatively short and significantly dilated
clinical3:40 ↗
The mesentery is taken down using a 3 mm bipolar vessel sealer, with vessels clamped, sealed, and then teased off the mesenteric border of the bowel
clinical4:10 ↗
The dissection was carried back almost to the ligament of Treitz and encompassed approximately 10 cm length of bowel
clinical4:30 ↗
A 5 mm endoscopic stapler was used to divide the bowel, laying down 4 rows of staples and dividing between them
clinical4:50 ↗
Two applications of the stapler were required because the bowel was so dilated, with a diameter of almost 4 cm
clinical5:10 ↗
The distal jejunal segment was anastomosed to the proximal dilated segment in an end-to-side fashion
clinical5:30 ↗
An enterotomy was made in the proximal dilated bowel using a 3 mm hook cautery and then decompressed with a 3 mm sucker
clinical5:45 ↗
A similar enterotomy was made in the distal jejunal segment and slightly dilated to allow access of the stapler
clinical6:00 ↗
The anastomosis was approximately 2.5 cm in length
clinical6:15 ↗
The resultant enterotomy was closed with a running absorbable suture
clinical6:25 ↗
Previous to having the stapler, an end-to-end anastomosis would have been performed with multiple interrupted or running sutures
clinical6:35 ↗
After completion of the enterotomy, there was no evidence of significant mesenteric defect or any gap in the anatomy
clinical6:50 ↗
The procedure took 80 minutes and was tolerated well by the infant
clinical7:05 ↗
The patient had diminishing NG aspirates over the next week
clinical7:20 ↗
An upper GI obtained one week postoperatively showed a widely patent anastomosis
clinical5:55 ↗
The resected specimen measured 10 cm
clinical5:55 ↗
Newborn had prenatal diagnosis of bowel obstruction and was found to have jejunal atresia on upper GI study
clinical0:00 ↗
Surgeon stands at baby's feet with cameraman on baby's right and scrub tech on patient's left
clinical0:30 ↗
3-port technique used with 4mm 30-degree scope for visualization and two 3mm ports for dissection
clinical0:50 ↗
Left mid quadrant port was later changed to 5mm for the stapler
clinical1:10 ↗
Veress needle is inserted below the umbilicus to avoid injury to umbilical vessels and prevent CO2 embolism
clinical1:20 ↗
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