We talked to the surgeon yesterday for my tiny human's intestinal malrotation. They are going to do surgery on June 11th. They're going to go in laparoscopically and look around. They are definitely going to remove her appendix b/c it's in the middle of her abdomen (near her belly button, instead of the lower right where it's supposed to be). If they find it necessary they are going to do what is called the Ladd procedure where they correct a number of issues. If they find that everything is okay with the current placement of her intestines and resembles what they would end up with when they do the Ladd procedure they're going to do a different procedure called Nissen fundoplication. They don't know exactly what they're going to be doing until they get in there and see what everything looks like. There will be two doctors doing the operation. She will stay in the hospital for a few days afterwards so they can monitor her. If they do the if they do the Ladd's procedure they will see how well it works and then decide if they need to do the other one later. Rather than doing everything all at once unnecessarily.
The Ladd's procedure is the standard corrective measure for intestinal malrotation in children and consists of division of peritoneal bands (Ladd's bands) traversing the posterior abdomen, reduction of volvulus, appendectomy, and functional postioning of the intestine with or without fixation.
Laparoscopic Nissen fundoplication is a minimally invasive procedure which is done to restore the function of the lower esophageal sphincter (the valve between the esophagus and the stomach) by wrapping the stomach around the esophagus.
They pretty much have no idea what they're going to find when they go in, but they always take the appendix b/c if she were to ever have appendicitis it wouldn't follow typical symptoms b/c of the location and it would be difficult for a surgeon to find b/c it'd be in the wrong place.
I asked why they never noticed it before and they said even though they did an abdominal ultrasound unless they were specifically looking for her appendix they wouldn't have noticed it was misplaced.
