Laparoscopically assisted surgery for congenital gastric or duodenal diaphragm in children.

Presented are our recent experiences with successful laparoscopically assisted surgery in two children with congenital gastric or duodenal diaphragm. Laparoscopy was used as an adjunct in performing the following surgical procedures: (1) inspection of the entire bowel, (2) identification and evaluation of the involved site, and (3) mobilization and exteriorization of the involved site. A minimal transverse incision was made for exteriorization. Extracorporeal removal of the diaphragm was followed by pyloroplasty or duodenoplasty. Each patient had a rapid and uncomplicated recovery with complete resolution of the symptoms. Laparoscopically assisted surgery may be a valuable modality in pediatric patients with congenital gastric or duodenal diaphragm. It allows better assessment of the entire bowel, minimizing the disfiguring and morbid abdominal incisions, without impeding the effectiveness of the planned operation. Avoidance of full-scale laparotomy may decrease the risk of future adhesions. These advantages seem attractive especially for children with longer life expectancy.