Minimally invasive surgery in neonates and infants

Lin, Tiffany V.; Pimpalwar, Ashwin

doi:10.4103/0971-9261.69133

Cited by 12 publications

(5 citation statements)

References 38 publications

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“…Formal thoracotomy remains the standard method for resection. Thorascopic surgery was being advocated by some [30–32]. Advocates of this approach argued that the small incisions may reduce the risk of musculoskeletal deformity, including chest wall asymmetry, scoliosis, rib fusion and winging of the scapula reported after posterolateral thoracotomy.…”

Section: Discussionmentioning

confidence: 99%

Retrospective study of prenatal diagnosed pulmonary sequestration

et al. 2013

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Purpose To describe the prenatal findings, treatments and outcomes of fetuses with pulmonary sequestrations (PS), which were retrospectively studied. Methods From May 2010 to January 2013, 292 women were referred to the Guangdong Women and Children Hospital, Guangzhou because obstetric ultrasound had demonstrated fetal lung lesions. In 68 fetuses, the echogenic lung masses were pulmonary sequestrations deriving arterial blood supply from clearly identifiable systemic arteries rather than the pulmonary artery. We examined records of the 68 fetuses and measured the lesions and congenital cystic adenomatoid malformation volume ratio (CVR), provided prenatal counseling and treatment, documented the CVR, location of lesion, gestational age at diagnosis, need for fetal intervention, perinatal clinical course (including the development of hydrops, effusions, and neonatal respiratory distress), gestational age at delivery, postnatal ultrasound and CT, operation treatment, survival and pathology. Results There were 68 PS in our study. All of 56 cases with CVR ≤1.6, survived without prenatal hydrops or postnatal respiratory symptoms. In 12 cases with CVR >1.6, 7 cases (58.3 %, 7/12) had hydrops, 10 cases (83.3 %, 10/12) survived, 2 cases (16.7 %, 2/12) of induced abortion, 8 cases (66 %, 8/12) were postnatal symptomatic. There was statistical significant difference in the incidence rate of hydrops and postnatal respiratory symptoms between the PS with CVR ≤1.6 and that with CVR >1.6. 66 cases postnatal survived, two cases of induced abortion. 64 cases had no prenatal treatment, two cases underwent thoracoamniotic shunt. The mean gestational age at birth was 38 weeks (range 34–40 weeks). 21 asymptomatic cases had no surgery. 45 cases (8 symptomatic and 37 asymptomatic) underwent surgical resections, 43 cases without postoperative complications, two cases of postoperative pneumothorax, no wound infection. Postoperative follow-up showed good growth in all surgery cases. Conclusion PS specific absence of hydrop was a congenital disorder with an excellent prognosis. CVR >1.6 was associated with fetal hydrops and postnatal symptoms. However, absolute CVR value cannot be used to select fetuses for fetal treatment before the development of hydrops. Surgery of PS in neonates or infants presented a good outcome.

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Section: Discussionmentioning

confidence: 99%

Retrospective study of prenatal diagnosed pulmonary sequestration

et al. 2013

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“…Laparoscopy, these days is a well-accepted modality in the treatment of a wide range of surgical problems in children. [ 10 11 12 13 14 15 ] The truth is, diagnostic laparoscopy for impalpable testes was the fore-runner of paediatric laparoscopy and now laparoscopy is also widely practiced in other fields of paediatric urology. [ 16 17 18 19 20 21 22 23 24 25 ] Laparoscopic cutaneous ureterostomy can be done either by retroperitoneoscopy or by transperitoneal route and retroperitoneoscopy has the advantage of avoiding possible intra-abdominal adhesions while transperitoneal approach facilitates bilateral procedures.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopy-assisted cutaneous ureterostomy at suprapubic creaseline facilitates subsequent reimplantation

Hannan

2015

J Min Access Surg

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BACKGROUND:Cutaneous ureterostomy is still practiced despite a trend towards primary surgical correction for obstructive or refluxive uropathy. For future open reimplantation, ureterostomy can be created by minimal invasive technique at the end(s) of the suprapubic creaseline.MATERIALS AND METHODS:From 1 January 2009 to 31 July 2012, seven children were treated with laparoscopy-assisted cutaneous ureterostomy followed by ureteric reimplantation. Indications were primary obstructive megaureter 3, hugely dilated ureters with reflux 3 and posterior urethral valve with poor general health 1. The distal manoeuverable part of tortuous ureter was pulled to the surface at either end of suprapubic creaseline to create the stoma. During reimplantation, this stoma was dismembered and brought inside urinary bladder obviating the need for stoma-site repair.RESULTS:Mean age was 4.6 ± 2.8 years with six males. There were three bilateral cases with total 10 lesions. Mean operating time was 39.8 ± 12.5 minutes. Mean follow-up was 1.7 ± 0.8 years and except for peri-stomal excoriations no major complication occurred. All these were reimplanted 6-12 months after ureterostomy and faring well except in one case.CONCLUSIONS:Laparoscopy-assisted cutaneous ureterostomy can be fashioned at suprapubic creaseline to facilitate future reimplantation without much jeopardy and extra scar.

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“…Many GI birth defects can be surgically treated with good prognosis for normal development and function later on as the babies grow into childhood. When newborns have medical problems that prevent them from taking adequate nutrition by mouth, a gastrostomy tube (G-tube) insertion procedure is typically conducted (Lin & Pimpalwar, 2010), whereby the G-tube is inserted through the abdomen for direct delivery of nutrients to the patients' stomach. Annually, about seven babies per 10,000 live births have GI associated birth defects.…”

Section: Gastrointestinal Implantsmentioning

confidence: 99%

Applications and challenges of using 3D printed implants for the treatment of birth defects

Wickramasinghe

Navarreto-Lugo

2018

Birth Defects Research

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Pediatric implants are a special subclass of a vast number of clinically used medical implants, uniquely designed to address the needs of young patients who are at the onset of their developmental growth stage. Given the vulnerability of the implant receiver, it is crucial that the implants manufactured for small children with birth-associated defects be given careful considerations and great attention to design detail to avoid postoperative complications. In this review, we focus on the most common types of medical implants manufactured for the treatment of birth defects originating from both genetic and environmental causes. Particular emphasis is devoted toward identifying the implant material of choice and manufacturing approaches for the fabrication of pediatric prostheses. Along this line, the emerging role of 3D printing to enable customized implants for infants with congenital disorders is presented, as well as the possible complications associated with prosthetic-related infections that is prevalent in using artificial implants for the treatment of birth malformations.

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Minimally invasive surgery in neonates and infants

Cited by 12 publications

References 38 publications

Retrospective study of prenatal diagnosed pulmonary sequestration

Retrospective study of prenatal diagnosed pulmonary sequestration

Laparoscopy-assisted cutaneous ureterostomy at suprapubic creaseline facilitates subsequent reimplantation

Applications and challenges of using 3D printed implants for the treatment of birth defects

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