LAPAROSCOPIC-ASSISTED PNEUMATIC REDUCTION OF INTUSSUSCEPTION

The nonoperative treatment of intussusception is done by fluoroscopy, however, false-positive and negative images may lead to unnecessary op erations. The aim of this study was to evaluate the feasibility of lap aroscopy in pneumatic reduction. Surgical ileoileocolic intussusceptio n was performed in 27 dogs. Sixteen dogs were observed for 3 days (gro up A), and 11 were observed for 5 days (group B). Laparoscopy was perf ormed in the intussuscepted dogs during pneumatic reduction. Under gen eral anesthesia, a 10-mm trocar was inserted supraumblically in the mi dline, and the laparoscope was introduced. The intussuscepted bower wa s observed on the video monitor. A 5-mm trocar was inserted in the rig ht upper quadrant. The mesentery of the terminal ileum was manipulated using grasping forceps to assist reduction. CO2 was insufflated into the rectum using a Foley catheter, and the reduction was observed on t he video monitor. The success rate was 94% (mean reduction time, 2.5 m inutes +/- 1.0) for group A and 100% (mean reduction time, 3.7 minutes +/- 0.8) for group B. Bowel perforation was observed in one dog, and recurrence of intussusception in another. The authors claim that obser ving the bowel on the video monitor may help in the differential diagn osis and reduction of difficult cases such as ileoileocolic and delaye d intussusceptions, Therefore, unnecessary open surgery may be prevent ed. Copyright (C) 1997 by W.B. Saunders Company.