By Felix Schier, Salmai Turial
When Laparoscopy in Children was once first released in 2003, it speedy turned well-liked by pediatric surgeons all over the world due to its transparent schematic drawings and concise textual content. This new version has been revised and enlarged to hide the recent strategies and different advances that experience emerged within the intervening interval, in which the variety of operations has virtually doubled. Now, the majority of symptoms for laparoscopy in young ones are offered and mentioned. every one operation is systematically defined and illustrated step-by-step, offering the reader with the technical guidance required to accomplish laparoscopy properly even in young children. Laparoscopy in Children can be a useful consultant for all surgeons who practice, or plan to accomplish, such operations.
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Additional resources for Laparoscopy in Children
3); otherwise, we postpone transection until the upper pouch is exposed and opened. In case the lung gradually enlarges in the meantime and obstructs view, we wait a few minutes. The view will improve spontaneously. The anesthesiologist pushes the nasogastric tube down. This helps to identify the upper segment, just as in the open approach. A small opening is made into the pleura at this area. The upper segment is grabbed with a forceps and bluntly freed from the surrounding tissue. With a good bite, the upper pouch can be rolled up so that the more cranial attachments can be visualized and transected more easily.
11 The surgeon’s view Fig. 13 With high tension, the first suture is brought in and out through the chest wall and closed by sliding down the trocar 37 Fig. 12 When all bowel loops are down, they will stay down Fig. 4 3 Thoracoscopic Procedures Lung Biopsy The patient is positioned and tilted in such a way that gravity pulls the collapsed lung away from the target area (Fig. 15). The first trocar for the 5-mm scope is inserted like a chest tube (skin incision, spreading with scissors, blunt advancement).
2 H-Fistula Fig. 8 Blunt dissection between esophagus and trachea Fig. 10 Fistula ligated but not transected 35 Fig. 3 3 Thoracoscopic Procedures Diaphragmatic Hernia For diaphragmatic hernia we have tried the approach from above (thoracoscopic) and from below (laparoscopic). The thoracoscopic approach was easier. The minimally invasive approach is suitable in otherwise healthy children. If, however, the child is seriously compromised, an “open” subcostal approach is quicker. Trocar position: The patient lays on his healthy side, unfortunately.