Groundbreaking Laparoscopic Surgery Saves 11-Year-Old Polytrauma Patient

Groundbreaking Laparoscopic Surgery Saves 11-Year-Old Polytrauma Patient

A Landmark Achievement in Pediatric Trauma Surgery at Kauvery Hospital

In a remarkable feat of surgical expertise, Kauvery Hospital successfully performed a laparoscopic repair of a diaphragmatic injury in an 11-year-old girl who sustained severe polytrauma following a road traffic accident. This case underscores the advancements in minimally invasive surgery (MIS) and pediatric trauma care, setting a benchmark for future trauma management.

The Accident That Changed Everything

Sony (name changed), an 11-year-old girl, was rushed to the emergency department after suffering multiple injuries in a road accident. The extent of her trauma was critical, including:

• Degloving injury to the right lower abdomen and thigh.
• Fractures in the right pubic rami and sacral ala.
• Multiple rib fractures and hemopneumothorax (air and blood accumulation in the chest cavity).
• Severe kidney injury with internal bleeding in the abdominal cavity.

Given the complexity of her injuries, the medical team at Kauvery Hospital acted swiftly. The immediate interventions included chest tube insertion to treat the lung injury and ventilatory support to stabilize her condition. Additionally, she underwent wound debridement, split-thickness skin grafting (SSG), and vacuum-assisted closure (VAC) dressing for her lower limb injury. She was then closely monitored in the intensive care unit (ICU).

A Hidden Threat – The Diaphragmatic Tear

Despite initial stabilization, further evaluation through a CT scan uncovered a posterior diaphragmatic tear, causing the stomach fundus to herniate into the chest cavity. This rare and often missed injury posed a significant risk of respiratory distress and gastrointestinal complications.

Recognizing the urgency of the situation, the surgical team opted for a minimally invasive laparoscopic approach to repair the crushed crus of the diaphragm. This decision was driven by the need to minimize surgical trauma and expedite recovery.

Executing a High-Risk Laparoscopic Surgery

The surgical team, led by Dr. Ganesh Shenoy, employed five laparoscopic ports to access and repair the damaged diaphragm. The intricate procedure involved:

• Exposing the diaphragmatic hiatus by carefully dividing the blood vessels supplying the stomach’s greater curvature.
• Identifying the full extent of the injury, which included blood accumulation behind the spleen and a severely crushed left diaphragmatic crus.
• Repositioning the herniated stomach back into the abdominal cavity.
• Performing a cruroplasty, suturing the damaged left crus to the opposite side using non-absorbable sutures in a tension-free manner.
• Gastropexy, securing the stomach to the anterior abdominal wall to prevent future migration into the chest.

The entire high-risk procedure was completed laparoscopically, demonstrating the hospital’s expertise in complex pediatric trauma surgery.

Swift Recovery and a New Lease on Life

Post-surgery, Sony was closely monitored in the ICU. Remarkably, she was able to tolerate oral feeds within 24 hours, and by the second day, she was successfully extubated. Her steady recovery enabled an early discharge, with stable vitals and an optimistic prognosis.

Dr. Ganesh Shenoy reflected on this milestone, stating, “Laparoscopic repair in a severely injured child is an enormous challenge. The presence of multiple injuries heightened the risk, but our team’s precision and expertise ensured the best possible outcome. Her rapid recovery is a testament to the advantages of minimally invasive surgery.”

Overcoming Surgical Challenges

This pioneering laparoscopic approach was not without its challenges:

• Polytrauma complications: Managing multiple injuries, including pelvic fractures and soft tissue damage, required careful intraoperative planning.
• Lung injury and chest tube presence: Persistent air leakage limited the operative field.
• Hidden diaphragmatic injury: The posterior location of the tear required a high index of suspicion and meticulous exploration.
• Restricted movement due to concurrent injuries: The thigh and abdominal trauma made laparoscopic instrument maneuverability more complex.

A Defining Moment in Pediatric Trauma Care

This case redefines the role of laparoscopy in pediatric trauma, proving that minimally invasive techniques can be safely applied even in severely injured young patients.

Dr. Ganesh Shenoy highlighted the significance of this achievement: “This was more than just saving a life; it was about preserving the patient’s future. The laparoscopic approach significantly reduced post-surgical pain, minimized scarring, and accelerated recovery, ensuring she could return to normal life much sooner.”

With continuous advancements in trauma surgery, cases like Sony’s pave the way for safer, faster, and more effective treatment options, offering young trauma victims a brighter and healthier future.

Conclusion

The successful laparoscopic repair of this 11-year-old polytrauma patient represents a turning point in pediatric trauma care. Kauvery Hospital’s commitment to cutting-edge surgical techniques and expert decision-making reinforces its position as a leader in life-saving innovations.

With such breakthroughs, the future of minimally invasive surgery in pediatric trauma cases looks promising, offering young patients not just survival, but a quality life post-recovery.