From the Research
The Ladd procedure involves several key steps to correct intestinal malrotation, including dividing abnormal peritoneal bands, widening the mesentery base, and arranging the intestines in the non-rotated position, as described in the most recent study 1. The procedure is essential for preventing life-threatening complications of malrotation, such as intestinal ischemia and necrosis. Some key points to consider when performing the Ladd procedure include:
- Dividing any abnormal peritoneal bands (Ladd's bands) that cross over and compress the duodenum
- Widening the mesentery base by mobilizing the duodenum and right colon
- Placing the small intestine on the right side of the abdomen and the colon on the left side (counterclockwise detorsion)
- Untwisting any volvulus in a counterclockwise direction
- Removing the appendix to prevent future diagnostic confusion
- Arranging the intestines in the non-rotated position and closing the abdomen. The Ladd procedure can be performed laparoscopically, which has been shown to be safe and effective in adults 1 and infants and children 2. The benefits of the laparoscopic approach include shorter operative time, hospital stay, and time to full feeds, as well as fewer overall postoperative complications and postoperative adhesive small bowel obstruction 2. However, the laparoscopic approach may have a higher risk of postoperative volvulus 2. Overall, the Ladd procedure is a crucial surgical technique for correcting intestinal malrotation and preventing its life-threatening complications.