1,720,993 research outputs found
Cryptorchidism
No full textThe term cryptorchidism refers to the condition of abnormal testicular descent (TD). In this situation the testis is âhiddenâ and it cannot be identified in its normal position that is inside the scrotum. In fact the term âcryptorchidismâ literally means âhidden testicleâ and is often used interchangeably with the term âundescended testicleâ. A normal testicular function is guaranteed by its full descent into the scrotum. Undescended testes carry the risk of malignant transformation and loss of fertility. It is thus mandatory to recognize this condition in order to plan the surgical correction
3d laparoscopic monitors
No full textMinimally invasive surgery (MIS) is a relatively new surgery comprising various procedures performed with special miniaturized instru- ments and imaging reproduction systems. Technological advances have made MIS an efficient, safe, and applicable tool for pediatric surgeons with unques- tionable advantages. The recent introduction of three-dimensional (3D) high definition systems has been advocated in order to overcome some of the problems related to standard MIS visual limitations. This short paper recapitulates the necessity to minimize MIS visualization limitations and reports the characteristics of new laparoscopic 3D system
Laparoscopic and retroperitoneoscopic pediatric urology
No full textMinimally invasive surgery (MIS) in pediatric urology has gained a great interest in the past few years. Early uses of laparoscopy had diagnostic purposes and were related to the management of non-palpable testes (1970s). MIS is now used for more complex and challenging procedures, and it accounts for 10â15 % of all pediatric laparoscopic surgeries performed by urologists. The evolution of pediatric MIS is the result of recent advances in camera technology and instrumentation and of the recognition of its safety. The benefits of laparoscopic surgery include reduced postoperative pain and hospital stay, quicker recovery, reduced complication rate, and excellent cosmetic results. MIS achieves good outcomes and high acceptance between parents despite the fact that there are still controversies
Laparoscopic patch repair of recurrent anterior diaphragmatic hernia in a child with SMA
Get PDFAn anterior congenital diaphragmatic hernia (CDH) is a diaphragmatic defect that allows the passage of abdominal organs into the thorax. It is typically asymptomatic (the diagnosis is incidental) and it requires surgical correction. In this paper we present a 6 year-old girl affected by spinal muscular atrophy (SMA) who was diagnosed with anterior CDH. Four years after laparoscopic closure of the defect by interrupted suture the girl returned for hernia recurrence. Another laparoscopic procedure was performed and the defect was closed using a GORE-TEX patch. We postulate a mechanism of altered respiratory dynamic and increased abdominal pressure related to scoliosis favouring CDH recurrence in patients with neuromuscular pathologies such as SMA. In these patients patch interposition should be considered in the first place in order to reduce tension over margins. Laparoscopy is a safe and feasible procedure for CDH correction also in case of recurrence and when the interposition of a patch is required. © 2014 Cantone et al
Laparo-Assisted Treatment of Intestinal Atresia: a single center experience
No full textIntroduction Jejuno-ileal atresia is the most common cause of congenital intestinal occlusion in newborns and the duodenal atresia is the most common cause of high bowel obstruction in the neonatal period
Nowadays the minimally invasive approach has been widely diffused and these surgical options are possible: circumbilical incision, the video-assisted and totally laparoscopic treatment. We present our experience with the video-assisted approach for the correction of intestinal atresias.
Material and Methods Seventeen patients with bowel atresia were treated by video-assisted procedure at our Institution. Surgical procedures consisted of identifying and exteriorization of the affected tract followed by traditional bowel atresia correction outside the abdomen.
Results All cases were successfully completed. There were no conversions to open surgery. One patient required a second procedure for an incomplete distal web that hadn’t been previously identified and another one experienced occlusion for intra-abdominal adhesions.
Discussion and Conclusions Our study supports the value of laparoscopy in the management of small bowel atresia providing a definitive diagnosis and directing subsequent surgical approach. The video assisted technique for the correction of small bowel atresia is safe, effective, and adds the advantages of the classic laparotomic procedure to the laparoscopic ones
Bronchogenic Cyst in a Child: the use of a 5 mm stapler for thoracoscopic resection
No full textWe report the case of a 4 year old patient affected by congenital bronchogenic cyst who underwent thoracoscopic surgery for cyst removal. A new 5 mm stapler device was used for the first time at our institution: its characteristics allowed us to safely perform the procedure with the advantages of using a 5 mm trocar
Intussusception
No full textThe term intussusception refers to the invagination of the part of the intestine into the adjacent segment. It is one of the most common causes of acute abdomen in children. Idiopathic intussusception is more frequent within the first 2 years of age with most cases presenting at around 6 months of age. Symptomatic intussusception with a pathologic lead point can occur at any age, especially in older patient. Idiopathic intussusception seems to be related to an intestinal dysmotility after weaned or gastrointestinal/respiratory infections. The main symptoms are colic abdominal pain, vomit, and “red currant jelly stool.”
Ultrasounds (US) are the first-level investigation for the diagnosis: the intussuscepted tract appears as two rings of low echogenicity with an intervening hyperechoic ring similar to a donut or a target. Contrast enema confirms the diagnosis and can be curative allowing progressive reduction of intussusception. In case of failure of the conservative treatment, a surgical approach is necessary. Classical operation is performed by laparotomy (small right-sided transverse incision). The intussusception mass is palpated and is brought outside the wound, and the reduction is attempted by exerting gentle and persistent pressure at its distal end. Laparoscopic reduction has been described as an effective alternative with reduced scarring, adhesions, pain, and hospitalization length although its role is still questioned. Delay in diagnosis is the main factor related to morbidity and mortality
Laparoscopic-assisted anorectal pull-through for high imperforate anus: 14 years experience in a single center
No full textPurpose: To report our 14 years experience with the laparoscopic-assisted anorectal pull-through (LAARP) for the treatment of male neonates with high imperforate anus. Materials and Methods: We reviewed all medical charts of patients who underwent LAARP from January 2001 to January 2015 collecting information regarding demographic data, associated anomalies, type of fistula, pelvic floor muscles tropism, surgery (operative time, conversion to open technique, and complications), and follow-up. Follow-up data were obtained through the use of validated questionnaires that aim to assess the intestinal function in terms of constipation and continence. Results: At the Department of Pediatric Surgery of the University of Bologna, 13 male patients were operated in the study period (our protocol consisted of colostomy at birth followed by delayed LAARP). Mean age at operation was 4.75 months (range 1-14). There was one conversion to open technique due to a strong tension from the colostomy (this patient was excluded). Functional results were acceptable at a minimum 2-year-long follow-up. Conclusions: LAARP is a good choice for the correction of the high imperforate anus. Short-term outcomes are similar to those after posterior sagittal anorectoplasty (PSARP). Long-term outcomes should be better assessed
Cloacal and urogenital sinus anomalies
No full textThe persistence of cloacal and urogenital sinus remains one of the most challenging problems for pediatric urologist. In this chapter we will describe the characteristics of these malformations in terms of diagnosis, clinical presentation, surgical treatment, and complications
Antenatal and perinatal management of urinary malformations
No full textAfter the introduction of maternal US in the 1970s, many urinary tract anomalies are found in utero. On one hand this permits early diagnosis and treatment, avoiding debilitating sequelae to little children. On the other hand, there are many anomalies with no clinical significance and destined to disappear that are labeled as dangerous, creating a discomfort to the child and to the mother as well. The goal of the prenatal diagnosis is not only to obtain a differential diagnosis between pathologies that have similar elements on prenatal US but also to define the prognosis. The collaboration between specialists is fundamental for this purpose. In this context, the chapter takes into consideration various aspects of the prenatal diagnosis and perinatal management of urinary malformations
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