44126 Enterectomy, resection of small intestine for congenital atresia, single resection and anastomosis of proximal segment of intestine; without tapering

Name of the Procedure:

Enterectomy, Resection of Small Intestine for Congenital Atresia, Single Resection and Anastomosis of Proximal Segment of Intestine; Without Tapering

Summary

An enterectomy is a surgical procedure in which a section of the small intestine affected by congenital atresia (blockage) is removed. The surgeon then reconnects the remaining healthy sections of the intestine. In this specific case, the resection involves the proximal segment of the intestine without tapering.

Purpose

The procedure addresses congenital atresia of the small intestine, a condition where a segment of the intestine is absent or blocked from birth. The goal is to restore the continuity of the intestine, allowing for normal digestion and absorption of nutrients.

Indications

• Congenital atresia of the small intestine
• Symptoms such as vomiting, abdominal distension, and inability to pass stool in a newborn
• Confirmation via prenatal ultrasound or postnatal imaging that shows intestinal blockage.

Preparation

• The patient (typically a neonate) should undergo a fasting period as recommended by the pediatric surgeon.
• Preoperative assessments may include imaging studies such as X-rays or ultrasounds, blood tests, and hydration status evaluation.
• Parents are usually counseled on the procedure, risks, and recovery.

Procedure Description

1. The patient is placed under general anesthesia.
2. A surgical incision is made in the abdomen to access the small intestine.
3. The affected segment of the small intestine is identified and removed.
4. The two healthy ends of the intestine are brought together and connected (anastomosis).
5. In this scenario, no tapering (narrowing) of the intestine is required.
6. The abdominal incision is closed, and the patient is stabilized.

Duration

The procedure typically takes 2 to 3 hours, depending on the complexity of the case.

Setting

This surgery is performed in a hospital operating room equipped for pediatric surgeries.

Personnel

• Pediatric Surgeon
• Anesthesiologist
• Surgical Nurses
• Operating Room Technicians

Risks and Complications

• Common risks: infection, bleeding, and anastomotic leak (leakage at the site where the intestines are joined).
• Rare complications: bowel obstruction, strictures (narrowing of the intestine), and prolonged ileus (temporary paralysis of the bowel).

Benefits

• Restoration of normal intestinal function and digestion.
• Relief from symptoms associated with congenital atresia.
• Improved growth and development once nutrient absorption is normalized.

Recovery

• Post-procedure, the patient is monitored in the neonatal intensive care unit (NICU).
• Pain management is provided via medications.
• Oral feeding is gradually introduced as bowel function returns.
• Recovery typically takes a few weeks, with follow-up appointments to monitor progress.

Alternatives

• In some cases, temporary ostomy procedures might be performed followed by a later anastomosis.
• Minimal invasive techniques may be explored in less severe cases.
• However, the described procedure is generally the most effective for congenital atresia.

Patient Experience

• Parents can expect their child to remain in the hospital for close monitoring.
• The neonatal patient will be under sedation during the surgery and will not experience pain.
• Post-operative discomfort is managed with pain medications, and parents will receive guidance on care and feeding during the recovery period.