Elliptical seromuscular resection for tapering the proximal dilated bowel in duodenal or jejunal atresia

The authors developed a surgical technique to taper the proximal dilated bowel in patients with duodenal or jejunal atresia. An appropriately wide elliptical piece of the seromuscular layer along the antimesenteric border is resected, with its underlying submucosa and mucosa kept intact. The muscular margins are approximated by sutures, with the mucosa either inverted or imbricated into the bowel lumen. This technique has the advantage of avoiding infection, leakage, or protrusion of thick bowel wall into the bowel lumen, which may produce a motility disorder.