Reduction of intussusception under general anesthesia by hydrostatic technique: the RIGHT technique

Abstract

Intussusception is the one of the commonest causes of intestinal obstruction requiring urgent attention in early childhood. There is no gold standard of non-operative reduction. We report our 6 years’ experience in non-operative reduction using our “RIGHT” (Reduction of Intussusception under General anesthesia using Hydrostatic Technique) technique, emphasizing the need to perform the procedure in the operating room (OR) under general anesthesia. This prospective observational study covering the period from July 2014 till May 2020 included patients diagnosed with intussusception. Hydrostatic reduction was performed in the OR under general anesthesia by infusing a saline enema and the reduction was confirmed by ultrasound. Forty-eight patients underwent reduction using the RIGHT technique. Successful reduction was achieved in 44 (91.6%) patients. Four (8.3%) patients needed surgery, three (6.2%) due to failed reduction and one (2.0%) due to perforation. One (2.2%) patient developed a recurrence. The “RIGHT” technique is a combination of the best available techniques of reduction of intussusception. It ensures patient safety by being performed in the OR, being pain free, avoiding radiation, avoiding the risk of aspiration associated with sedation, and also being able to immediately address a failure of reduction or a complication by surgical exploration.