Abstrakt

Laparoscopic Ladd’s procedure for intestinal malrotation in the adult patient without volvulus: Surgical technique

Christine Wang, Tyrone Rogers, Katherine Su, Eugene P. Ceppa*

The most feared complication of intestinal malrotation is midgut volvulus, vascular compromise, and eventual bowel necrosis due to the narrow mesenteric base associated with malrotation which suspends the entire midgut vasculature. Although the large majority of those with malrotation become clinically symptomatic within the first two years of life, a small portion of patients enter adulthood undiagnosed. Nevertheless, treatment of intestinal malrotation is performed surgically using the Ladd procedure. However, adults are still commonly treated with an open technique due to its infrequency in the adult population despite the well-reported safety and efficacy of a minimally invasive technique. To encourage its use for the correction of rotational anomalies without volvulus, we describe in detail the surgical technique of the laparoscopic Ladd procedure in the adult patient using real-time intraoperative images.