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J Indian Assoc Pediatr Surg. 2011 Jan;16(1):8-10. doi: 10.4103/0971-9261.74513.

Laparoscopy-assisted hydrostatic in situ reduction of intussusception: A reasonable alternative?

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1
Department of Paediatric Surgery, Gandhi Medical College and Hospital, Hyderabad, Andhra Pradesh, India.

Abstract

AIM:

To evaluate an alternative way of reducing intussusceptions under laparoscopic guidance.

MATERIALS AND METHODS:

This is a retrospective observational study of children who underwent laparoscopy-assisted hydrostatic in situ reduction of intussusceptions (LAHIRI). Under general anesthesia with laparoscopic vision, warm saline was infused into the rectum with a 16-18 F Foley catheter and a drip set till the intussusception was reduced.

RESULTS:

Eleven patients [age 7.8 (±2.8) months] were operated over a period of 1 year. Ten (90.9%) patients had ileocolic intussusception, which got completely reduced, but one (9%) had ileo-ileocolic intusussception, in whom manual reduction by extending the subumbilical incision was required to reduce the ileoileal part. The mean duration of surgery was 38.5 (±6.6) min. No patient had bowel ischemia and there were no intra- or postoperative complications.

CONCLUSIONS:

LAHIRI appears to be an effective and safe technique in children. Specific advantages are that it is performed in a controlled environment in the operating room, avoids patient apprehension and discomfort, avoids bowel handling, provides a safe opportunity to create higher intraluminal pressure, ensures visual assessment of bowel vascularity and completeness of reduction.

KEYWORDS:

Hydrostatic reduction; intussusceptions; laparoscopy

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