Pediatric Minimal Access Surgery (No Series)

Front cover......Page 1
Preface......Page 6
Contents......Page 8
Contributors......Page 12
1 Introduction: An Evidence-Based Approach to Pediatric Minimal Access Surgery......Page 16
1. CREATION OF EVIDENCE......Page 17
3. EVIDENCE-BASED PEDIATRIC MINIMAL ACCESS SURGERY......Page 18
REFERENCES......Page 20
1. EVOLUTION OF TECHNOLOGY......Page 22
2. APPLICATION OF MAS TO SURGICAL PRACTICE......Page 25
3. APPLICATION TO PEDIATRIC SURGERY......Page 27
4. FUTURE OUTLOOK......Page 28
REFERENCES......Page 29
1. INTRODUCTION......Page 30
2. GENERAL CONSIDERATIONS 2.1. Patient Selection......Page 31
2.2. Patient Positioning......Page 32
2.3. Anesthetic Considerations......Page 33
2.4. Pain Management......Page 34
3. CARDIORESPIRATORY EFFECTS OF MINIMAL ACCESS SURGERY 3.1. Laparoscopy......Page 36
3.2. Thoracoscopy......Page 38
4. ANESTHETIC IMPLICATIONS OF INTRAOPERATIVE COMPLICATIONS......Page 41
REFERENCES......Page 42
1. INTRODUCTION......Page 44
2. THORACOSCOPIC AND LAPAROSCOPIC INTERVENTIONS 2.1. Indications......Page 46
3.2. Limited Working Space......Page 48
3.4. Cannula Fixation......Page 50
3.6. Insertion of Secondary Cannulae......Page 51
REFERENCES......Page 52
5 Clinical Outcomes in Minimal Access Fetal Surgery......Page 56
1. CONGENITAL DIAPHRAGMATIC HERNIA......Page 59
2. TWIN– TWIN TRANSFUSION SYNDROME......Page 65
3. TWIN REVERSED ARTERIAL PERFUSION AND TWINS DISCORDANT FOR A LETHAL ANOMALY......Page 67
4. OBSTRUCTIVE UROPATHY......Page 69
5. SACROCOCCYGEAL TERATOMA......Page 75
6. MYELOMENINGOCELE......Page 77
7. TENSION HYDROTHORAX......Page 78
8. CONGENITAL HEART DEFECTS......Page 80
9. PREMATURE RUPTURE OF MEMBRANES......Page 83
11. GASTROSCHISIS......Page 84
12. POTENTIAL FUTURE APPLICATIONS OF MINIMAL ACCESS FETAL SURGICAL TECHNIQUE......Page 85
REFERENCES......Page 86
1. INTRODUCTION......Page 96
2. ROLE OF MINIMAL ACCESS SURGERY......Page 97
3. TECHNIQUE OF TRAUMA LAPAROSCOPY......Page 99
4. THE ROLE OF THORACOSCOPY IN THORACIC TRAUMA......Page 100
5. SUMMARY......Page 101
REFERENCES......Page 102
1. INTRODUCTION......Page 104
2. THORACOSCOPIC LUNG BIOPSY......Page 106
3. THORACOSCOPIC MEDIASTINAL BIOPSIES......Page 107
3.1. Future Possibilities......Page 108
3.2. Complications of Thoracoscopic Procedures for Malignancy......Page 109
5. LAPAROSCOPIC EXPLORATION FOR A SECOND-LOOK OPERATION......Page 110
7. LAPAROSCOPIC ADRENALECTOMY......Page 111
8. LAPAROSCOPIC RETROPERITONEAL LYMPH NODE SAMPLING......Page 112
10. SUMMARY......Page 113
REFERENCES......Page 114
8 Complications of Pediatric Minimal Access Surgery......Page 118
2. GENERAL COMPLICATIONS 2.1. Access......Page 119
2.2. Pneumoperitoneum......Page 122
2.3. Cardiopulmonary......Page 124
2.4. Other......Page 127
3.2. Harmonic Scalpel......Page 129
5. COMPLICATIONS OF RETROPERITONEOSCOPY......Page 130
5.5. Access Failure......Page 131
6. REDUCING THE CHANCE OF COMPLICATIONS......Page 132
REFERENCES......Page 133
Specific Disease and Procedures in Pediatric General Surgery......Page 138
9 Minimal Access Surgical Approaches to Childhood Hepatobiliary and Pancreatic Disorders......Page 140
1.2. Choledocholithiasis......Page 141
1.3. Approach to the Jaundiced Infant......Page 142
1.5. ERCP and MRCP......Page 143
1.7. Biliary Atresia......Page 144
2. PANCREAS 2.1. Pancreatic Pseudocyst......Page 145
2.2. Laparoscopic Pancreatectomy......Page 146
3.2. Staging Laparoscopy......Page 147
REFERENCES......Page 148
10 Laparoscopic Splenctomy......Page 152
1. TECHNICAL FACTORS AND CONVERSION RATES......Page 153
2. ACCESSORY SPLEEN DETECTION......Page 156
4. PAIN......Page 157
6. COST......Page 158
7. COMPLICATIONS AND LONG-TERM SEQUELAE......Page 159
REFERENCES......Page 161
2. TECHNICAL CONSIDERATIONS......Page 166
4. PEDIATRIC EXPERIENCE......Page 168
REFERENCES......Page 170
12 Outcomes Following Laparoscopic Pyloromyotomy for Infantile Hypertrophic Pyloric Stenosis......Page 172
3. POSTOPERATIVE RECOVERY......Page 173
5. COMPLICATIONS......Page 175
6. CONCLUSIONS......Page 177
REFERENCES......Page 178
1. INTRODUCTION......Page 180
2. PATHOPHYSIOLOGY OF GER......Page 181
3. CLINICAL MANIFESTATIONS......Page 183
4. DIAGNOSTIC EVALUATION......Page 184
5. TECHNIQUE......Page 185
6. GASTROSTOMY......Page 192
7. POSTOPERATIVE MANAGEMENT......Page 194
8. RESULTS......Page 197
9. THE CHILDREN’S MERCY EXPERIENCE......Page 198
REFERENCES......Page 201
2. GASTROSTOMY......Page 204
2.2. Percutaneous Endoscopic Gastrostomy......Page 205
2.3. Laparoscopic Gastrostomy......Page 207
2.4. Gastrostomy Device Considerations......Page 209
3. JEJUNOSTOMY......Page 211
REFERENCES......Page 212
1. DIAGNOSIS......Page 216
2.2. Pneumatic Dilation......Page 217
2.4. Open Surgical Intervention......Page 218
REFERENCES......Page 219
1. INTRODUCTION......Page 224
3. LAPAROSCOPIC APPENDECTOMY TECHNIQUES......Page 225
4. LAPAROSCOPIC APPENDECTOMY COMPARED TO OPEN APPENDECTOMY......Page 226
5. APPENDICEAL MASS, LAPAROSCOPY, AND THE INTERVAL APPENDECTOMY......Page 228
REFERENCES......Page 229
1. INTRODUCTION......Page 232
2.2. Surgical Technique......Page 233
3.1. Presentation and Indications for Surgery......Page 234
4. SMALL BOWEL OBSTRUCTION......Page 235
5. INTUSSUSCEPTION......Page 236
REFERENCES......Page 237
2. OPERATIVE TECHNIQUE......Page 240
3. RESULTS......Page 247
REFERENCES......Page 248
1. INTRODUCTION......Page 250
4. TRANSANAL (PERINEAL) PULLTHROUGH......Page 251
6. TIMING OF ONE-STAGE PULLTHROUGH......Page 252
REFERENCES......Page 253
1. INTRODUCTION......Page 256
2. HISTORY OF SURGICAL REPAIR OF ARM......Page 257
3. ANATOMY AND PHYSIOLOGY......Page 259
4. MANAGEMENT AND CLASSIFICATION......Page 261
5.1. Single-Stage Approach......Page 262
6.2. Trocar Placement......Page 263
6.3. Dissection......Page 264
6.4. Pull-Through......Page 265
6.5. Anoplasty......Page 268
7. POTENTIAL COMPLICATIONS......Page 269
8. DISCUSSION/OUTCOME......Page 270
REFERENCES......Page 272
1. INTRODUCTION......Page 276
2.1. Cystic Ovarian Lesions......Page 277
2.2. Solid Ovarian Lesions......Page 278
3. A DIAGNOSTIC APPROACH TO OVARIAN MASSES......Page 279
4.1. Fetal and Neonatal Cysts......Page 280
4.4. Solid Ovarian Lesions......Page 281
REFERENCES......Page 282
1. INTRODUCTION......Page 286
3. CLASSIFICATION......Page 287
5. CLINICAL PRESENTATION......Page 288
5.4. Asymptomatic......Page 289
6. DIAGNOSIS......Page 290
8.1. Laparoscopic Treatment......Page 291
8.2. Technique......Page 292
8.3. Results in Patients Without Volvulus......Page 293
8.4. Results in Patients with Volvulus......Page 296
REFERENCES......Page 297
1. INTRODUCTION......Page 300
5. OPERATIVE SET-UP......Page 301
7. COMPLICATIONS......Page 302
8. DISCUSSION AND CONCLUSIONS......Page 303
REFERENCES......Page 304
2. HISTORY......Page 306
4. PRINCIPLES OF THE TECHNIQUE......Page 307
5.2. Laparoscopic Two-Step FS Procedure for IAT......Page 308
6. COMPLICATIONS......Page 309
7. DISCUSSION AND CONCLUSIONS......Page 310
REFERENCES......Page 311
1. INTRODUCTION......Page 312
2. LUNG BIOPSY......Page 313
3. LOBECTOMY......Page 314
4. PNEUMOTHORAX......Page 315
REFERENCES......Page 316
2. PRINCIPLES OF EMPYEMA MANAGEMENT......Page 318
4. THE EVOLUTION OF SURGICAL APPROACHES TO EMPYEMA DRAINAGE......Page 320
5.1. Safety and Effectiveness of VATD......Page 321
5.2. Comparison of VATD with Thoracotomy for Empyema......Page 324
6. CONCLUSIONS......Page 325
REFERENCES......Page 326
27 Mediastinum, Esopagus, and Diaphragm......Page 328
REFERENCES......Page 331
1. INTRODUCTION......Page 334
2.1. Bypass Procedures......Page 335
3. MALABSORPTIVE VS. RESTRICTIVE PROCEDURES......Page 336
4. PEDIATRIC OBESITY DEFINED......Page 337
6. RATIONALE FOR BARIATRIC SURGERY IN ADOLESCENTS......Page 339
7. RECOMMENDED COMPONENTS OF A MULTIDISCIPLINARY TEAM......Page 340
REFERENCES......Page 341
1. INTRODUCTION......Page 346
3. CLINICAL PRESENTATION AND EVALUATION......Page 347
4. INDICATIONS......Page 349
5. OPEN SURGICAL REPAIR......Page 350
6. OUTCOMES AND COMPLICATION OF STANDARD REPAIRS......Page 351
7. MINIMALLY INVASIVE REPAIR OF PE (THE NUSS PROCEDURE)......Page 352
8. EVIDENCE-BASED OUTCOME OF THE NUSS PROCEDURE......Page 353
9. MODIFICATIONS TO THE NUSS PROCEDURE......Page 358
REFERENCES......Page 360
Minimal Access Surgery in Other Pediatric Surgical Specialities......Page 362
30 Minimal Access Surgery in Pediatric Urology......Page 364
2. UPPER URINARY TRACT......Page 365
2.1. Renal Access......Page 366
2.2. Nephrectomy......Page 368
2.3. Partial Nephrectomy......Page 370
2.4. Pyeloplasty......Page 372
3.1. Treatment of Vesicoureteral Reflux......Page 373
4. COMPLICATIONS OF LAPAROSCOPIC UROLOGICAL PROCEDURES......Page 375
REFERENCES......Page 376
1. INTRODUCTION: HISTORICAL PERSPECTIVE......Page 382
2. HYDROCEPHALUS......Page 383
2.1. Third Ventriculostomy......Page 385
3. ENDOSCOPIC TREATMENT OF INTRACRANIAL CYSTS......Page 387
3.1. Arachnoid Cysts......Page 388
3.2. Colloid Cyst......Page 391
5. GENERAL GOAL OF TREATMENT OF AVM......Page 393
5.1. Microsurgical Excision of AVM......Page 394
5.2. Embolization of AVM......Page 395
5.3. Radiosurgery......Page 396
5.4. Success of Radiosurgery for AVMs......Page 398
6. NEURONAVIGATION......Page 399
6.2. Accuracy......Page 402
REFERENCES......Page 404
32 Minimal Access for Surgery in Pediatric Spinal Surgery......Page 408
2. HISTORY OF THORACOSCOPY AND THORACOSCOPIC SPINAL SURGERY......Page 409
3. ENDOSCOPIC ANATOMY......Page 410
5. CONTRAINDICATIONS......Page 411
7.2. Endoscopic Instruments......Page 412
7.5. Procedure......Page 413
7.8. New Advances in Technique......Page 414
8. EXPERIENCE AT THE CHILDREN’S HOSPITAL MEDICAL CENTER, CINCINNATI......Page 415
9. VATS VS. THORACOTOMY......Page 417
10. VATS-ASSISTED ANTERIOR INSTRUMENTED SPINAL FUSION......Page 419
11. COMPLICATIONS 11.1. Intraoperative Complications......Page 420
12. CONCLUSION......Page 421
REFERENCES......Page 422
1. INTRODUCTION......Page 424
2. SURGICAL TECHNIQUES 2.1. Modifications to the Heart– Lung Machine......Page 425
2.2. Surgical Incisions......Page 426
2.3. Video-Assisted Cardiac Surgery (Cardioscopy)......Page 427
2.4. Robotic Video-Assisted Cardiac Surgery......Page 428
2.6. Robotic Fetal Techniques......Page 430
BIBLIOGRAPHY Brain Protection and Selective Cerebral Perfusion......Page 433
Surgical Incisions/Cardioscopy/Video-Assisted Robotics......Page 434
Telemanipulation/Fetal Work......Page 435
34 The Interventional Radiologist's Role in Pediatric Minimally Invasive Surger......Page 436
1. INTRODUCTION......Page 437
2.2. Imaging Modalities......Page 438
2.3. Equipment......Page 440
3. PREPROCEDURE CARE 3.1. Preprocedure Workup......Page 442
3.3. Sedation/Analgesia/Anesthesia......Page 443
5. BASIC/COMMON PROCEDURES......Page 444
5.1. Vascular Access......Page 445
5.2. Enteral Access......Page 447
5.3. Biopsies......Page 450
5.4. Drainages......Page 453
6.2. Tracheal Stenting......Page 456
7. BILIARY INTERVENTIONS......Page 457
7.3. Biliary Drainage......Page 458
7.6. Transjugular Intrahepatic Portosystemic Shunt......Page 459
8.1. Treatment of Vascular Malformations......Page 461
9. FUTURE DIRECTIONS......Page 462
REFERENCES......Page 463
Future Directions......Page 476
1. INTRODUCTION......Page 478
3. ETHICAL ISSUES 3.1. Adaptation vs. Innovation and Experimentation......Page 479
3.2. Informed Consent and Learning Curves......Page 480
3.4. Evidence-Based Technology Assessment......Page 481
3.5. Economical and Social Cost of New Technologies......Page 482
5. THE CASES......Page 483
REFERENCES......Page 484
1. INTRODUCTION......Page 486
4. PRINCIPLES FOR SKILLS CURRICULUM DESIGN 4.1. Psychomotor Skill Acquisition......Page 487
4.3. Skill Retention......Page 488
4.4. Surgical Innovation......Page 489
5.2. We Should Create and Administer the Best Skills Courses......Page 490
5.5. We Should Provide Leadership in Documenting the Improvement That Educational Courses Have in Practice......Page 491
REFERENCES......Page 492
1. INTRODUCTION......Page 494
2.2. Haptic Limitations......Page 495
3. ROBOTICS IN SURGERY......Page 496
4. CLASSIFICATION OF ROBOTIC SURGERY SYSTEMS......Page 497
5.1. The Zeus System......Page 498
5.2. The da Vinci System......Page 500
6. APPLICATION OF ROBOTIC TECHNOLOGY TO PEDIATRIC SURGERY......Page 501
7. FUTURE DIRECTIONS......Page 505
8. CONCLUSION......Page 506
REFERENCES......Page 507
Index......Page 510
Back cover......Page 520