Pneumatically Assisted Laparoscopic Reduction of Intussusception

Abstract

Intussusception is a common abdominal emergency in children. When nonoperative therapy fails, surgery becomes necessary. The authors report their experience with minimal access surgery for the reduction of ileocolic intussusception. Laparoscopic reduction of ileocolic intussusception was performed in four children, between 4 and 19 months of age, who presented with intussusception refractory to pneumatic reduction. The technique involves establishment of pneumoperitoneum via the umbilicus followed by insertion of the laparoscope to confirm the diagnosis. Two laparoscopic bowel forceps are introduced through the abdominal wall to reduce the intussusception. Pneumatic assistance is performed by instilling air through a Foley catheter positioned in the rectum preoperatively. All four patients underwent a successful laparoscopic reduction and were discharged home within 24 hours after surgery. There were no complications and no recurrences. These results demonstrate that pneumatically assisted laparoscopic reduction of intussusception offers a safe and effective alternative to open reduction with all of the benefits of minimal access surgery.