Why Laparoscopic Surgery Is Preferred For Neonatal Surgery

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Dr Nada Sudhakaran

Paediatric Surgeon & Urologist

Neonatal Laparoscopic Surgery Is the Preferred Method for Oseophageal Atresia & Duodenal Atresia

There are several conditions that a newborn may be born with that could necessitate surgical intervention. The comparison of the outcomes and recovery between traditional open surgical techniques and minimally invasive, keyhole or laparoscopic surgery is crucial.

In this article, we explore two such neonatal conditions, Oesophageal Atresia and Duodenal Atresia, to highlight why laparoscopic surgery is often the preferred choice for neonatal conditions.

Understanding Neonatal Conditions

Oesophageal Atresia

Oesophageal Atresia is a congenital condition where the oesophagus, the tube connecting the mouth to the stomach, is not continuous. The upper oesophagus ends in a blind pouch, and often the lower oesophagus is connected to the airway. Children with this condition are unable to swallow since the oesophagus is discontinuous, necessitating surgical intervention to reconnect the upper and lower oesophagus.

For a full article on Oseophageal Atresia in children click HERE

Traditional Open Surgery for Oesophageal Atresia

Traditionally, a significant incision under the armpit is required for open surgery in Oesophageal Atresia cases. This incision provides access to the oesophagus for surgical instruments or sometimes even a hand. The process involves cutting the skin, sometimes muscle, and opening up the space between the ribcage. This approach can lead to considerable post-operative pain and deformity, and over 40% of children undergoing this method may develop scoliosis, a spinal condition, in the long term.

Open Surgery
Open surgery incisions – large in size to allow access to hand manipulation by surgeon

Duodenal Atresia

Duodenal Atresia is another congenital condition, similar to Oesophageal Atresia, but it occurs in the duodenum, which is a structure just beyond the stomach. In this condition, the duodenum is blind-ending, and the downstream part is collapsed, necessitating surgery to connect the two parts.

Traditional Open Surgery for Duodenal Atresia

The conventional surgical approach for Duodenal Atresia requires a significant abdominal incision to access the duodenum. This approach also involves cutting muscle and other overlaying structures. The recovery from this surgical method is often challenging due to pain and scarring.

Laparoscopic Surgery: A Better Approach

Laparoscopic or thoracoscopic (keyhole) surgery offers a better alternative to traditional open surgery for both Oesophageal Atresia and Duodenal Atresia.

Less Invasive, Faster Recovery: As the incisions are significantly smaller, the procedure is less invasive, leading to quicker recovery and less postoperative pain.

Reduced Scarring: Due to the minimalistic incisions, scarring is significantly reduced compared to open surgery.

No Disruption or Damage to Structures/Organs: One major advantage is that because of the tiny instruments used in Laparoscopic procedure there is much less chance of secondary damage to organs or structures.

Identification of Internal Issues: The keyhole method also provides the opportunity to check for any other internal injuries or abnormalities.

Laparoscopic Surgery for Oesophageal Atresia

In laparoscopic surgery for Oesophageal Atresia, three small instruments are introduced into the chest via minor stab incisions, allowing surgeons to access the oesophagus and reconnect the upper and lower oesophagus without causing significant injury to the chest wall. This approach avoids the need for a large incision and does not disrupt the rib space, preventing long-term chest deformities and the risk of scoliosis.

Laparoscopic Surgery for Duodenal Atresia

In the case of Duodenal Atresia, laparoscopic surgery allows surgeons to connect the two parts of the duodenum using three minor incisions. This approach is less disruptive to stomach function compared to the open technique, and patients recover significantly faster. Moreover, laparoscopic surgery results in minimal scarring compared to the large scars resulting from traditional open surgery.

Pediatric Appendicitis Surgery
Keyhole surgery incisions – 3 small dots to insert camera and two instruments.

Patient Story – Lily’s Duodenal Atresia Surgery

My name is Kevin and this is our adorable little daughter, Lily. Today I want to share with you a remarkable and positive experience that we had with minimally invasive surgery and this gave Lily the opportunity to be the normal, happy, healthy baby she is today.

Unfortunately, Lily was diagnosed with a condition known as Duodenal Atresia, and this is where her stomach and small intestine are not properly connected. As I’m sure you can imagine it was an extremely stressful time for us as parents, particularly because Lily couldn’t feed, she couldn’t take on any milk and she required the use of an intravenous drip at that time.

However, thanks to Dr. Nada and the option of using minimally invasive surgery (keyhole), we were able to find a solution that I genuinely believe had the best outcomes for Lily, medically and for her own physical and mental wellbeing.

One of the advantages that we saw with our own eyes was that she experienced minimal pain using the surgery. The procedure required only three tiny incisions. It looked like lines and the marks are barely noticeable on her body. We hope that with an application of a simple cream, those scars will essentially disappear.

Post operation Lily’s recovery was really remarkable. Instead of her worrying about pain from a big cut, she was actually very content and she could just focus on getting better, practicing her feed feeding. The surgery appears to have had no impact on the rest of her body, such as any internal organs or her spine.

We can’t thank Dr Nada enough for his expertise and compassion and the way in which he kept us fully informed at all steps of the process.

Finally, we’re just so grateful for this opportunity to share our experience with all of you. Minimally invasive surgery truly made a significant difference in Lily’s life, and we hope that it can make a difference in many more lives of other children in Malaysia.

Once again, a big thank you to you, Dr Nada, and from a happy healthy Lily – bye!

Conclusion: Provide Your Child With The Benefits of Laparoscopic Surgery

Laparoscopic surgery has revolutionized the treatment of neonatal conditions such as oesophageal atresia and duodenal atresia. The minimally invasive nature of this surgical approach leads to less pain, faster recovery, and minimal scarring, making it a preferred choice for many surgeons and parents.

As awareness about the benefits of laparoscopic surgery increases, more parents are seeking surgeons who are skilled in this technique, particularly for neonatal conditions.

Find out more HERE

If you require surgical help with your child, schedule an appointment with Dr Nada and put your mind at ease knowing that your child is in good hands.

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Dr Nada Sudhakaran

Paediatric Surgeon & Urologist

Paediatric Surgeon


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Pantai Hospital Kuala Lumpur

+603-2296 0419

Sentosa Specialist Hospital Klang

+603 5162 8814

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