One stage laparoscopic Ladd procedure, appendectomy and Nissen fundoplication in 7-year old boy

The film presents laparoscopic operation in 7 -year-old boy with duodenal subileus and gastroesophageal reflux disease. It was assumed that gastro-esophageal reflux is secondary to partial obstruction of the duodenum. Intraoperative examination revealed adhesion of the stomach with the front wall of the abdomen and liver (spontaneous - no earlier operations), solid fibrous bands pinching and bending descending part of the duodenum and hiatal hernia. Ladd's bands were released for decompression and straightening the course of the duodenum, appendix was resected (cecum was located in the left upper abdomen) and typical antireflux procedure (Nissen fundoplication) was done. Three procedures were performed during a one laparoscopic surgery. The operative time was 100 min. The postoperative course was uneventful . Currently , the year after the intervention, patient does not present any symptoms occured before surgery. The operation was performed in the Department of Surgery of Malformations Children and Traumatology in Zabrze.