Experience with laparoscopic enucleation of enteric duplication cysts in neonates and infants

Aim: To present our clinical experience with the effective use of laparoscopic enucleation for enteric duplication cysts in newborns. Materials and Methods: This retrospective study included 20 pediatric patients diagnosed with gastrointestinal duplication cysts who underwent laparoscopic cyst enucleation between 2018 and 2021. A key technical feature of the procedure was the avoidance of monopolar coagulation in favor of cold dissection using laparoscopic scissors. After complete excision of the cyst’s mucosal layer, the intestinal wall was reconstructed with a muscular-serosal flap derived from the cyst wall. Cysts were localized in various segments: stomach (n = 2), duodenum (n = 3), small intestine (n = 14), and colon (n = 1). The mean age at surgery was 40 ± 35.3 days (range: 6 days to 5 months). Results: The mean operative time was 84.4 ± 27.35 minutes. No intraoperative complications were reported. All patients received parenteral nutrition for 3-5 days postoperatively. Complications occurred in three cases: two children developed bowel perforation requiring enterostomy, and one experienced intestinal volvulus necessitating segmental bowel resection. All complications occurred in patients who underwent enucleation with monopolar coagulation. In the subsequent 15 cases, enucleation was performed using only laparoscopic scissors, with no complications observed. The mean postoperative hospital stay was 15.6 ± 10.48 days. No cases of intestinal stenosis or cyst recurrence were recorded during follow-up. Conclusion: Laparoscopic enucleation is a safe and effective surgical approach for managing enteric duplication cysts in neonates and infants. The technique preserves the continuity of the intestine without requiring segmental resection. Cold dissection with scissors minimizes the risk of complications associated with thermal injury to the intestinal wall.

gastrointestinal duplication, enteric cyst, laparoscopy, enucleation, intestinal wall reconstruction, children

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