Laparoscopically harvested omental flap for recurrent tracheoesophageal fistula in a newborn baby

Management of Recurrent Tracheoesophageal Fistulas: A Systematic Review

“…40 Many authors recommend placement of an interposition tissue between the sutured ends of the esophagus and trachea to prevent a second recurrence; these include mediastinal pleura, [41][42][43][44][45] vascularized pedicle of pericardium, 31,32,46 pedicled sternocleidomastoid flap, 40 coastal cartilage graft, 47 and omental flaps. 48 The postoperative care is similar to after an ET.…”

Recurrent Tracheoesophageal Fistula

“…4,38 In cases where no suitable local vascularized tissue is available for suture line separation, recent reports have described using omentum or autologous free fascia lata grafts. Bonnard et al 39 described laparoscopically creating an omental pedicle flap immediately before thoracotomy and rTEF repair. The omental pedicle flap was then brought through the hiatus and placed between the esophageal and tracheal repair.…”

Omental Flap Provides Definitive Management for Pediatric Patient With Multiple Tracheoesophageal Fistula Recurrences

“…We present a child that had 3 TEF recurrences which were all appropriately managed with commonly used surgical techniques. 1-3 Below we report on the technique we used in the last repair where an omental flap was placed between the esophageal anastomosis and tracheal suture line.…”

“…Well-described examples of interposed tissue include pericardium, pleura, or a strip of intercostal muscle. 1-3 During the first and second procedure, our patient’s interpositional flaps were made of pleura and intercostal muscle, respectively. Without knowledge of the procedure described by Bonnard et al, we used an omental flap for our patient’s final repair as the other more common tissue flaps had failed.…”