The role of laparoscopy in the management of childhood intussusception

Background: Some authors have argued that intussusception is best treated v ia a laparoscopic approach. As we did not have this impression, we reviewed our experience with this condition. Methods: We reviewed all patients with intussusception who were treated at our hospital over the past 10 years. The choice of whether to use a laparos copic or open approach depended on the patient's clinical condition and the availability of surgeons with laparoscopic expertise. Results. A total of 72 patients were identified. Based on age, two subgroup s were distinguished-one comprised of patients under the age of 3 years and one of patients over the age of 3 years. Sixty-five patients were under 3 years of age. Thirty-five had surgery, and 19 required resection. Of the 10 patients who were treated with a laparoscopic approach, only three could b e reduced laparoscopically. After conversion in the other seven patients, t he intussusception was reduced in five whereas a resection was required in two cases. Seven patients were 3 years of age or older, Ah of them underwen t surgery, and all but one required resection. All four children who were l aparoscoped subsequently had a bowel resection at open surgery. Conclusions: Patients 3 years of age or older usually need resection and wi ll not benefit from the laparoscopic approach. Under 3 years of age little is to be gained from a laparoscopic approach, provided good nonsurgical red uction facilities are available. There is a place for the laparoscopic appr oach in eases of recurrent intussusception or doubtful reduction.