Laparoscopic Excision of Duodenal Web

Duodenal mobilisation

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On initial laparoscopic views the stomach was normal and the duodenum was hugely dilated. The dilated duodenum was mobilised with to reach up to the web area. In the process the duodenum was hitched up to the abdominal wall with prolene suture to help in mobilisation.

Keywords

  • Stomach
  • Duodenum
  • Abdominal Wall

Conflict of Interest

The author declares no conflict of interest.

About this video

Author(s)
Ravi P. Kanojia
First online
07 August 2020
DOI
https://doi.org/10.1007/978-981-15-7021-6_1
Online ISBN
978-981-15-7021-6
Publisher
Springer, Singapore
Copyright information
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2020

Video Transcript

So our initial target was to cauterize the entire “C” of the duodenum and start with duodenal mobilization. There were extensive adhesions because of the previous surgery with the gallbladder and the colon down below. A careful mobilization is needed here, because you can potentially injure both either the duodenum or the colon.

So you can see that this is dilated duodenum all along its course, and we are dividing all the peritoneal attachments and the attachments with the colon next to it. Careful dissection is needed so that you preserve all the vital structures around. So these are probably the adhesions from the previous surgery. And you can see that there are a fair amount of Ladd’s bands also present, which are extending in this area.