- A telescopic invagination of a portion of the intestine into an adjacent part, producing mechanical and vascular impairment.
- Invagination is the insertion of one part of a structure within another part of the same structure, which is what happens with intussusception.
- This defect can be relieved by either reduction via hydrostatic pressure (usually barium enema) or by a laparotomy with manual manipulation if the defected segment.
- The most common site for intussusception is around the ileocecal valve, in which the terminal ileum becomes invaginated into the cecum.
- If not reduced, either spontaneously or by hydrostatic pressure, gangrene will ultimately ensue unless surgical intervention is prompt.
- Supine, with arms restrained at the sides.
- Pediatric laparotomy drape with basic pack.
- Pediatric laparotomy tray
- Internal sampling devices.
- Thermal blanket
- Needle counter
- Vessel loops
- Internal staples
- Basin set
- Needle counter
- Dissector sponges
- A transverse or low right paramedian incision is made and the peritoneum is entered.
- Manual manipulation is attempted to reduce the intussusception.
- Should the viability of the bowel be in question, however, a resection is performed in a fashion similar to that of an adult bowel resection, with a primary anastomosis or the ends of the bowel brought out as a stoma through separate incisions.
- With the latter, the anastomosis is performed as a secondary procedure.
- The abdomen is closed in a routine manner.
Perioperative Nursing Consideration
- The surgeon may require a clean closure set-up.
- If the bowel resection is performed, isolate all instruments, following bowel technique.
- When part of another procedure, the small bowel segment will be performed following the revision of the diseases area, and appropriate instrumentation for that procedure should be available.
- Bowel technique requires the total changeover of gowns, gloves, and instruments.