Laparoscopic Treatment of Duodenal and Jejunal Atresia and Stenosis

With the ongoing expansion of indications for endoscopic pediatric surgery and increasing experience with intracorporeal suturing, laparoscopic repair of duodenal atresia or stenosis is the challenge of the new century. In 2001 the first laparoscopic repair of a duodenal atresia was described by Bax et al. (2001), shortly followed by Rothenberg (2002) describing a series of four patients. Thereafter a few other publications have appeared (Gluer et al. 2002; Nakajima et al. 2003). Precise anatomical knowledge is necessary to determine the distal duodenum that runs posteriorly and needs to be mobilized to perform a diamond-shaped anastomosis (Kimura et al. 1977, 1990). Laparoscopic correction of jejunal atresia has not been described so far which is not surprising as the proximal jejunum is usually strongly dilated, which necessitates tapering.