StayCurrentMD · Laparoscopic Intestinal Duplication Cyst Repair - Technique
Video4 min·Published Nov 2018Older

Laparoscopic Intestinal Duplication Cyst Repair - Technique

With Dr. Dr. Steve Rothenberg · StayCurrentMD
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What the experts said2 expert statements · 16 host summaries
For vessels of this size, this maneuver is extremely efficient as it allows for rapid sealing and division of the mesentery without the repeated placement of endoscopic scissors
Opinion
This was a very fast and efficient way of closing the small enterotomy, with the surgeon able to follow himself keeping adequate tension on the running suture line to prevent any gaps
Opinion
A full-term infant with a prenatally diagnosed abdominal cyst underwent ultrasound which confirmed the presence of a duplication cyst
Host summary
At 3 weeks of age, the patient underwent laparoscopic exploration
Host summary
3 ports were used with ports in the right and left mid quadrant used for the manipulation and resection
Host summary
The intestinal duplication cyst appeared to be mid-jejunal
Host summary
The left mid quadrant port was upsized to a 5 millimeter port to allow for placement of the endoscopic stapler
Host summary
A single load of the stapler was used to divide the bowel both on the proximal and then on the distal end
Host summary
This allowed for division of the bowel without any intraabdominal contamination from the bowel contents
Host summary
The 3 millimeter vessel sealer was used to seal the mesentery and then it was stripped off the cyst in the bowel without any bleeding or other issues
Host summary
A 3-0 Prolene stitch was placed through the anterior abdominal wall and then placed through first the distal limb and then the proximal limb of the bowel to align the two segments for the side to side anastomosis
Host summary
A Vicryl stay suture was placed intracorporeally to align the proximal segments of the two pieces of bowel to facilitate the side to side anastomosis
Host summary
Two enterotomies were made side by side in each limb of the bowel to allow for placement of the 5 millimeter stapler
Host summary
A side to side anastomosis was completed with a single application of the stapler
Host summary
The resultant enterotomy was closed with a running 4-0 Vicryl suture
Host summary
A small specimen bag was placed into the abdomen using the thumb of a #8 glove
Host summary
The cyst was decompressed using cautery and suction to allow the bowel to fit in the bag
Host summary
The specimen was brought out through the left mid quadrant trocar site
Host summary