Laparoscopic repair of superior mesenteric artery syndrome

Background: Superior mesenteric artery syndrome is duodenal obstruction by the superior mesenteric artery. It is caused by decreasing the angle betwee n the aorta and superior mesenteric artery causing compression of the third part of the duodenum and usually occurs after a period of weight loss. Met hods: Between September 1999 and April 2000, 2 patients with superior mesen teric artery syndrome were treated laparoscopically. The laparoscope was pl aced in the umbilicus; the surgeon operated through two trochars on the lef t side of the abdomen, and an assistant retracted through one trochar on th e right side of the abdomen. The dilated duodenum was seen below the transv erse mesocolon and to the right Of the superior mesenteric artery. A proxim al loop of jejunum was anastamosed to the duodenum using the endoscopic gas trointestinal anastomotic (GIA) stapler. Results: Average operating time wa s 113 minutes and average hospital length of stay was 3 days. There were no complications and both patients were pleased with their results. Conclusio ns: Laparoscopic duodenojejunal bypass is feasible with laparoscopic techni ques. The operating time is acceptable and the postoperative length of stay is short. (C) 2001 Excerpta Medica, Inc. All rights reserved.