Neonatal bedside laparotomy in the UK: a multidisciplinary survey of practice and perceptions

Abstract Purpose Emergency neonatal laparotomy can be undertaken on the intensive care unit (ICU) or in the operating theatre. The evidence-base establishing indications, benefits or disadvantages is limited. We conducted a | multidisciplinary survey of UK neonatal surgical centres to describe current practice. Methods A 16-item online survey was developed, and responses sought from one anaesthetist, one neonatologist and one surgeon at each of the 25 neonatal surgery centres in the UK. Quantitative responses were analysed with descriptive statistics (IBM SPSS Statistics v30). Free-text responses were subjected to qualitative thematic analysis. Results 23 anaesthetists, 23 neonatologists, and 23 paediatric surgeons responded (69/75; 92%). At least one response was received from every centre. Cotside laparotomy is carried out in 22 (88%) of centres. 44 (64%) respondents preferred operating in theatre although a significant minority favoured cotside surgery (13 (19%)). Only 5 (20%) centres reported having formal indications for cotside laparotomy. Centres with established pathways performed a significantly higher proportion of cotside laparotomies compared to centres without established guidelines (p