Laparoscopic Repair of Duodenal Atresia: Systematic Review and Meta‐Analysis

Mentessidou, Anastasia; Saxena, Amulya K.

doi:10.1007/s00268-017-3937-3

Cited by 38 publications

(13 citation statements)

References 20 publications

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“…In our study, the median time to initiation of feeds, achievement of full feeds, and length of hospitalization in the laparoscopic group were similar to those of most other laparoscopic series ( 7 – 10 , 15 ). Another study showed that the laparoscopic approach reduces the length of hospitalization and time to initial feeds ( 5 ); however, it is thought that the difference between the feeding protocols based on the upper gastrointestinal contrast studies.…”

Section: Discussionsupporting

confidence: 85%

Transition from Laparotomy to Laparoscopic Repair of Congenital Duodenal Obstruction in Neonates: Our Early Experience

Cho

Kim

et al. 2017

Front. Pediatr.

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BackgroundThe aim of this report was to review our early experience of the last 7 years with repairs of congenital duodenal obstruction (CDO) to determine the efficacy and outcomes of laparoscopic repairs compared to laparotomy.MethodsA retrospective review was conducted on all neonate (<30 days) with CDO between 2009 and 2015. Patients with duodenal atresia, stenosis, web, and annular pancreas were included. Patients with only malrotation or delayed presentation were excluded.ResultsTwenty-six neonates underwent laparoscopy and 30 underwent traditional laparotomy. The operative time was longer in the laparoscopic group (P = 0.001), but time to initiation of feeds and time to full feeds were similar for the laparoscopic and open groups. There was no mortality, anastomosis leakage, or stenosis in the laparoscopic group. Six laparoscopic cases required conversion to an open procedure (23%). In the earlier cases, the open conversion rate was high, but it decreased over time (P = 0.003).ConclusionLaparoscopic repair is safe and effective for repair of CDO in neonates. Despite operative time was slightly longer in the laparoscopic group, clinical outcomes remained similar to the open group. For pediatric surgeon with experience in laparoscopic techniques, laparoscopic duodenoduodenostomy is a sufficient available procedure.

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Section: Discussionsupporting

confidence: 85%

Transition from Laparotomy to Laparoscopic Repair of Congenital Duodenal Obstruction in Neonates: Our Early Experience

Cho

Kim

et al. 2017

Front. Pediatr.

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“…Surgery time is one of the most objective and easily accessible indices of performance [6,12,13,25,26], which was found to be similar to those in clinical practice Fig. 4 Average GOALS score (A), depth perception score (B), bimanual dexterity score (C), efficiency score (D), tissue handling score (E) and overall performance score in the beginner and advanced groups for laparoscopic diamond-shaped anastomosis [22]. Owing to a standardized, structured MISTELS-based training in our study, the beginner group completed the tasks more slowly than the clinically experienced advanced group only at certain stages of the study.…”

Section: Discussionmentioning

confidence: 65%

“…Laparoscopic duodenal atresia repair is still one of the most challenging tasks in pediatric surgery [19,20] requiring advanced laparoscopic abilities, including meticulous dissection and laparoscopic intracorporal knotting skills [20][21][22]. Performance, however, greatly improves over time due to the increased number of repetitions in clinical settings [16].…”

Section: Discussionmentioning

confidence: 99%

Characterization of technical skill progress in a standardized rabbit model for training in laparoscopic duodenal atresia repair

et al. 2021

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Background Laboratory skills training is an essential step before conducting minimally invasive surgery in clinical practice. Our main aim was to develop an animal model for training in clinically highly challenging laparoscopic duodenal atresia repair that could be useful in establishing a minimum number of repetitions to indicate safe performance of similar interventions on humans. Materials and methods A rabbit model of laparoscopic duodenum atresia surgery involving a diamond-shaped duodeno-duodenostomy was designed. This approach was tested in two groups of surgeons: in a beginner group without any previous clinical laparoscopic experience (but having undergone previous standardized dry-lab training, n = 8) and in an advanced group comprising pediatric surgery fellows with previous clinical experience of laparoscopy (n = 7). Each participant performed eight interventions. Surgical time, expert assessment using the Global Operative Assessment of Laparoscopic Skills (GOALS) score, anastomosis quality (leakage) and results from participant feedback questionnaires were analyzed. Results Participants in both groups successfully completed all eight surgeries. The surgical time gradually improved in both groups, but it was typically shorter in the advanced group than in the beginner group. The leakage rate was significantly lower in the advanced group in the first two interventions, and it reached its optimal level after five operations in both groups. The GOALS and participant feedback scores showed gradual increases, evident even after the fifth surgery. Conclusions Our data confirm the feasibility of this advanced pediatric laparoscopic model. Surgical time, anastomosis quality, GOALS score and self-assessment parameters adequately quantify technical improvement among the participants. Anastomosis quality reaches its optimal value after the fifth operation even in novice, but uniformly trained surgeons. A minimum number of wet-lab operations can be determined before surgery can be safely conducted in a clinical setting, where the development of further non-technical skills is also required.

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“…They reported that the laparoscopic treatment is associated with lower postoperative morbidity, shorter recovering time and postoperative hospital stay, and better postoperative cosmesis than open surgery. Mentessidou and Saxena (2017) and Chung et al (2017) performed systematic reviews and found that laparoscopic repair was of comparable safety and efficacy as the open repair for duodenal atresia.…”

Section: Outcome and Long-term Resultsmentioning

confidence: 99%

Duodenal Obstruction

Sweed¹,

Yulevich²

2019

Pediatric Surgery

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Laparoscopic Repair of Duodenal Atresia: Systematic Review and Meta‐Analysis

Abstract: LRDA shows comparable safety and efficacy with the open repair, although it is associated with significantly longer operative time. There is no evidence that the type of the suture material or anastomotic technique affects the outcome of LRDA.

Cited by 38 publications

References 20 publications

Transition from Laparotomy to Laparoscopic Repair of Congenital Duodenal Obstruction in Neonates: Our Early Experience

Transition from Laparotomy to Laparoscopic Repair of Congenital Duodenal Obstruction in Neonates: Our Early Experience

Characterization of technical skill progress in a standardized rabbit model for training in laparoscopic duodenal atresia repair

Duodenal Obstruction

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