Ladd’s Surgery

After the day 2 catheter procedures were complete Tucker returned to the Neonatal Intensive Care Unit (NICU) to recover. After several days he no longer required such intensive care and was therefore transferred to the Surgical Recovery Floor. A few days later the doctors did an upper gastrointestinal test on Tucker’s stomach to determine if the situs inversus had an effect on his intestines and bowel.

The test required Tucker to drink contrast fluid and lay really still on a table while an x-ray machine tracked the fluid’s movement through his intestines and bowel. X-ray images were taken throughout the process from many different angles. The doctor studied these images and determined that not only are his intestines and bowel on the wrong side due to the situs inversus, but that he also has malrotation.

Malrotation is when the intestines and bowel due not form correctly. A volvulus, or twisting of the intestines, can occur due this improper formation. The twisting can cause intestinal blockage and cut off blood supply to that portion of the intestines. The lack of blood to this area can damage or destroy that section of the intestines. The malrotation also results in having bands of tissue form in the intestinal wall. These bands are called Ladd’s bands and their existence can also cause intestinal blockage.

The doctors decided that Tucker required the Ladd’s procedure, or surgery, due to this malrotation. Since his intestines and bowel did not form properly the doctors are unable to completely eliminate the possibility of volvulus occurring, but doing the surgery will drastically decrease the risk. Therefore on Tuesday June 25th, at 15 days old, Tucker went in for the surgery. The surgery involved the doctors relocating Tucker’s intestines and bowel and cutting out the Ladd’s bands. Due to the improper shape of the intestines and bowel the doctors are unable to place them in their proper locations, but were able to relocate them into the best possible way for Tucker. To do this surgery they made a 2″-3″ horizontal incision just above his belly button and slightly to his left side.

During the surgery they also removed his appendix. His appendix was located just below his sternum and was twice the proper length. If they didn’t remove it, and Tucker ever had appendicitis, it would be extremely hard to diagnose due to its location.

The day of the surgery was a very long day for Tucker and for us. The doctors required that he not be fed any more food after 4:00 AM even though they didn’t begin surgery until 3:30 PM. Tucker was starving and inconsolable all day. Hours later the doctors paged us to let us know the surgery was done and that everything went well. We were thankful and overwhelmed when we were finally allowed into the NICU to see Tucker around 7:00 PM that evening.

Helpful Links:

Malrotation: http://www.chop.edu/healthinfo/intestinal-malrotation-and-volvulus.html
or
http://www.seattlechildrens.org/medical-conditions/digestive-gastrointestinal-conditions/malrotation/

Post Ladd's Procedure

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