Laparoscopic Repair of Duodenal Perforation by “Hanging Method” -Technique and Benefits

Abstract

Background: Laparoscopic repair of duodenal perforation using the omental patch is one of the traditional techniques, which givesbetterpostoperativerecoveryinpatientswithlittlechancesof abdominalwoundinfection. Thisarticleisaboutthetechnique used for the laparoscopic repair of the duodenal perforation by Grahams patch with a twist in the conventional technique. Methods: In Hanging method of duodenal repair first, an intra-corporeal suture is taken at the upper margin of perforation and both end of the thread is taken out of anterior abdominal wall and duodenum is pulled up. Now under vision the next two parallel sutures are passed, thus avoiding the posterior duodenal wall incorporation. Finally omentum flap is used for the closure of perforation. Conclusions: The laparoscopic closure of the duodenal perforation by “Hanging Method” is an appropriate Laparoscopic tech-nique,as“hanging”theanteriorwallof duodenumgivesusbettervisionof theposteriorwallof duodenum,whiletakingthesuture through anterior duodenal wall. Further since the gall bladder is retracted there is an easy available working space for intracorporeal suturing.