Laparoscopic repair of superior mesenteric artery syndrome

Background: Superior mesenteric artery syndrome is duodenal obstruction by the superior mesenteric artery. It is caused by decreasing the angle between the aorta and superior mesenteric artery causing compression of the third part of the duodenum and usually occurs after a period of weight loss. Methods: Between September 1999 and April 2000, 2 patients with superior mesenteric artery syndrome were treated laparoscopically. The laparoscope was placed in the umbilicus; the surgeon operated through two trochars on the left side of the abdomen, and an assistant retracted through one trochar on the right side of the abdomen. The dilated duodenum was seen below the transverse mesocolon and to the right of the superior mesenteric artery. A proximal loop of jejunum was anastamosed to the duodenum using the endoscopic gastrointestinal anastomotic (GIA) stapler. Results: Average operating time was 113 minutes and average hospital length of stay was 3 days. There were no complications and both patients were pleased with their results. Conclusions: Laparoscopic duodenojejunal bypass is feasible with laparoscopic techniques. The operating time is acceptable and the postoperative length of stay is short