Intussusception treatment

Abstract

Operating room personnel positions and equipment are described. Indications for surgery include: failure of radiographic reduction, suspected incomplete reduction, suspected intussusception, and recurrent intussusception. Relative contraindications include a longstanding intussusception with the suspicion of inadequate intra-abdominal space in which to manipulate laparoscopic instruments. Diagnostic laparoscopy may reveal a successful preoperative reduction, and thus obviate the need for laparotomy. Successful laparoscopic reduction may require both antegrade squeezing of the intestine ("pushing") as well as gentle retrograde "pulling" of the intussusception. Continuous gentle traction on the intussuscepted intestine may allow successful reduction. An appendectomy can be done at the conclusion of the procedure. © 2009 Springer-Verlag Berlin Heidelberg.