Treatment of Ladds Procedure Surgery

Introduction

Ladd’s procedure surgery is a life-saving treatment performed to correct intestinal malrotation, a congenital condition in which the intestines do not develop in the normal position. This surgery is most commonly performed in infants and children, but adults with late diagnosed malrotation may also require it. Understanding how the treatment of ladds procedure surgery works, when it is needed, and what recovery looks like can help patients and families feel more confident about the treatment journey.

What Is Ladd’s Procedure Surgery?

Ladd’s procedure is a surgical technique used to treat intestinal malrotation, a condition in which the bowel twists abnormally around the superior mesenteric artery. This can result in volvulus, a dangerous twisting of the intestine that blocks blood supply and can cause life-threatening complications.

The aim of the surgery is to untwist the intestine, prevent future twisting, and position the bowel in a way that allows proper digestion and blood flow.

Why Is Ladd’s Procedure Needed?

Ladd’s procedure is typically recommended when a patient shows symptoms of malrotation or volvulus, such as

1. Sudden abdominal pain
2. Green (bilious) vomiting
3. Swelling of the abdomen
4. Feeding difficulties in infants
5. Chronic digestive problems in older kids or adults
6. Failure to thrive

If not treated urgently, volvulus can lead to severe bowel damage, infection, or even death. Therefore, once malrotation is diagnosed, corrective surgery is essential.

How Ladd’s Procedure Works: Step-by-Step Overview

Ladd’s procedure can be performed using open surgery or laparoscopic (minimally invasive) surgery. The choice depends on the patient’s age, condition severity, and the surgeon’s recommendation.

1. Untwisting the Intestine :- The surgeon first identifies the twisted bowel and gently untwists it to restore normal blood flow.
2. Dividing Ladd’s Bands :- Abnormal fibrous tissues, known as Ladd’s bands, may compress the duodenum (upper intestine). These bands are cut to relieve obstruction.
3. Widening the Mesentery :- The mesentery is the tissue that attaches the intestines to the abdominal wall. It is broadened to prevent future twisting.
4. Repositioning the Intestines :- Although the intestines cannot be placed in their original anatomical position, they are rearranged to minimize the risk of volvulus. Typically

• Small intestine is brought to the right side
• Large intestine is moved to the left side

5. Appendix Removal (Appendectomy) :- Because the appendix is moved to an unusual position during surgery, doctors often remove it to avoid future confusion in diagnosing appendicitis.

Ladd’s Procedure in Children vs. Adults

While the surgery is most common in infants, cases of malrotation may remain undetected until adulthood.

In infants

1. Symptoms appear early
2. Condition progresses rapidly
3. Emergency surgery is often required

In adults

1. Symptoms may be intermittent
2. Surgery may be planned rather than emergency
3. Minimally invasive techniques are more commonly used

Regardless of age, timely treatment leads to excellent outcomes.

Recovery After Ladd’s Procedure

Recovery varies depending on the severity of volvulus, patient’s health, and whether the surgery was performed in an emergency.

• Hospital Stay

1. Infants may need 5–14 days of hospitalization.
2. Adults may recover faster but could require several days of monitoring.

• Feeding and Digestion

1. Newborns may start feeding gradually once the bowel function returns.
2. Older patients may need a temporary special diet.

• Pain Management :- Medication is given to manage pain and support healing.
• Activity and Follow-Up

1. Gentle movements are encouraged early on.
2. Full recovery can take several weeks.
3. Regular follow-up ensures proper digestive function.

Benefits of Ladd’s Procedure

Ladd’s procedure offers several important advantages, including

1. Prevents recurrence of volvulus
2. Relieves bowel obstruction
3. Improves digestion and feeding
4. Protects intestinal blood supply
5. Reduces long-term complications

Most patients, especially infants, grow and develop normally after the surgery.

Possible Risks and Complications

Like all surgeries, Ladd’s procedure carries some risks, though complications are uncommon when treated promptly.

Potential risks include

1. Infection
2. Bleeding
3. Adhesions (scar tissue)
4. Recurrent obstruction (rare)
5. Bowel damage in severe cases of volvulus

Early diagnosis and expert surgical care significantly reduce complications.

Life After Ladd’s Procedure: Long-Term Outlook

Most children and adults who undergo Ladd’s procedure lead healthy, normal lives. Digestive symptoms generally improve significantly, and the risk of volvulus recurrence becomes extremely low. Parents and patients should watch for occasional digestive discomfort but, in most cases, no special long-term dietary restrictions are needed.

Conclusion

Ladd’s procedure surgery is a crucial and highly effective treatment for intestinal malrotation, preventing serious complications like volvulus and ensuring long-term digestive health. With timely diagnosis, skilled surgical care, and proper post-operative follow-up, patients from newborns to adults can expect excellent outcomes and a healthy life ahead.