By using the sonomorpohological criteria presented here, testicular viability can be appraised in all age groups to help determine the prognosis for testicular outcome. In PTT, a nonperfused, homogeneously appearing testis represents the initial phase of torsion. Only for this type is there hope for salvage. In addition to the intraoperative appearance, a testis that is preoperatively heterogeneous in appearance can support the decision for orchiectomy.

As a result of our findings, additional sealing of small-diameter intestinal anastomoses with TachoSil™ cannot be recommended.

We employ the TERPT procedure as the first choice in children with rectosigmoid HD.

In contrast to adult surgery, the neonatal small intestine confronts the surgeon, depending on the age of the patient, with variable diameters of the intestine. Therefore, anastomoses are usually performed by hand with interrupted sutures. In the presented study, a new technique is demonstrated. An anastomosis in the distal ileum of Sprague Dawley rats was performed with a single clamp applicator (Anastoclip). Small bowel anastomoses were performed in 32 rats. The clipped bowel anastomosis was evaluated concerning stenosis, leakage, and adhesions in comparison to the sutured anastomosis. Tension test and X-ray examination were performed to measure the stability. The rats were sacrificed at day 3 or 14 after laparotomy. The clipped anastomosis is feasible, and faster to perform than the conventional hand-sutured anastomosis (Operation time: control group: 18.5 min versus clipped group 4 min; p > 0.05). Furthermore, there were differences in the mechanical stability, with higher tension forces needed for rupturing the clipped anastomosis. There were fewer stenoses (16.5 mm stenotic diameter in the control group versus 20.6 mm in the clipped group) and fewer adhesions in the group of the clipped anastomosis. Histological examinations were performed and did not show significant differences between the two groups. In the animal model presented, the clipped, intestinal, non-perforating anastomosis (CINPA) shows advantages compared to the common hand-sutured anastomosis.

Among 131 children in whom an intestinal bowel anastomosis procedure was performed at age younger than 1 year, only 5 (3.2%) experienced complications associated with the anastomosis. The children are in good physical condition and have an excellent quality of life.