By N. M. A. Bax (auth.), N. M. A. Bax MD, PhD, Keith E. Georgeson MD, Azad S. Najmaldin MS, FRCS, Jean-Stéphane Valla MD (eds.)
Endoscopic surgical procedure in teenagers is a quickly increasing box in pediatric surgical procedure. This ebook represents the state-of-the-art, and explains why endoscopic surgical procedure in kids is so very important. normal facets are mentioned and targeted details is equipped on many particular operations either within the chest in addition to within the stomach, together with endoscopic remedy of throracic scoliosis, of urogenital stipulations, and of neurosurgical stipulations. program of endoscopic thoughts in oncology is mentioned besides. a unique bankruptcy bargains with complications.
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Extra info for Endoscopic Surgery in Children
Hanna, C. Kimber, A. Cuschieri The operative work space is significantly reduced in children due to their small abdominal cavity and the minimal distension created by low pressure pneumoperitoneum. In addition, particularly in neonates, the liver is relatively larger, and the abdomen is greater transversely than it is lengthwise. Further difficulties occur in kypho-scoliotic patients, particularly those undergoing fundoplication. The equipment set-up should be discussed with the anaesthetist as the endoscopic instruments often compromises the access to the child.
Internal knotting. 1,2, Positioning the suture;3,4, first component double throw; 5, repositioning the ends; 6, 7, second component single throw; 8, re-positioning; 9, third component singlethrow 2 3 4 s 6 7 8 9 .. 3 Basic Technique 31 Fig. 21 a,b. Hinges ofthe needle holder or grasping forceps used for suturing. a Smooth hinge. 22a-c. Introducing the needle/suture into the abdominal cavity. b Holding the suture attached to the needle. 23. Continuous suturing. A grasping forceps align tissues. A rubber-shod grasper keeps tension on the suture line without damaging the material that both instruments have boxed-in hinges to allow a smooth glide over the instrument and prevent tangling at the hinge (Fig.
Appropriate shoulder and side supports, with or without strappings and wedge blocks, permit change of patients' position during the operation. In paediatric patients the whole abdomen is usually prepared and draped. This is because the site of cannulae insertion are often away from the operative field, and an unplanned or additional cannula may be necessary for retraction or manipulation, or wide access may be necessary for conversion to emergency open surgery. The cables/leads are secured to the drapes in such a way that they cause no obstruction to access the patient and movement around the operating table by the surgeon, anaesthetist and the theatre staff.