Image-guided Percutaneous Drainage in the Pediatric Population: A Primer for Radiologists

Image-guided percutaneous drainage is an excellent minimally invasive method for dealing with infectious complications in the pediatric population. A thorough understanding of drainage procedures in children can often lead to improved patient outcomes. Indications for percutaneous drainage will be reviewed, including abscesses related to appendicitis, post-surgical abscess formation, and abscesses related to Crohn's disease. This pictorial essay will help the radiologist better understand the common etiologies of abscesses in children that may require percutaneous drainage, the special considerations for catheter placement, patient preparation, and anesthesia or sedation issues unique to the pediatric population.

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MINIMALLY INVASIVE LUMBAR DISCECTOMY IN OBESE PATIENTS

Neurosurgery ◽

10.1227/01.neu.0000290900.23190.c9 ◽

2007 ◽

Vol 61 (3) ◽

pp. 539-544 ◽

Cited By ~ 43

Author(s):

John S. Cole ◽

Thad R. Jackson

Keyword(s):

Minimally Invasive ◽

Patient Outcomes ◽

Patient Population ◽

Chart Review ◽

Infectious Complications ◽

Invasive Technique ◽

Complication Rates ◽

Incision Length ◽

Disc Herniations ◽

Near Future

Abstract OBJECTIVE To assess patient outcomes and complication rates after minimally invasive lumbar microdiscectomy in an obese patient population. METHODS A retrospective clinical review of 32 patients with a body mass index of 30 kg/m2 or greater undergoing lumbar minimally invasive discectomy was performed. The initial chart review was followed by phone interview if all information could not be obtained from chart review. Demographic and pertinent pre-, peri-, and postoperative data were obtained. RESULTS Favorable clinical outcomes were obtained in all patients except one, indicating that they would undergo operative intervention again. Most patients reported minimal or no leg or back pain. Twenty-five of the patients did not require any chronic analgesia. The overall complication rate was 12.5%. Two patients had recurrent disc herniations requiring reoperation and one patient required fusion for a pars defect and subsequent subluxation. CONCLUSION Lumbar minimally invasive discectomy is our preferred surgical technique for symptomatic disc herniations in this patient population. Decreased incision length and a trend toward reduced infectious complications are the primary reasons. We feel that, given the comorbidities often found in this patient population, a minimally invasive technique will supplant open approaches in the near future.

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CT-guided percutaneous drainage of abdominopelvic collections: a pictorial essay

La radiologia medica ◽

10.1007/s11547-021-01406-z ◽

2021 ◽

Author(s):

Massimo De Filippo ◽

Sara Puglisi ◽

Fabiano D’Amuri ◽

Francesco Gentili ◽

Ilaria Paladini ◽

...

Keyword(s):

Minimally Invasive ◽

Percutaneous Drainage ◽

Ultrasound Guidance ◽

Recent Literature ◽

Mortality Rates ◽

Invasive Treatment ◽

Ct Guided ◽

Pictorial Essay ◽

Fluid Collections ◽

Indications And Complications

AbstractCT-guided percutaneous drainage is a safe and effective procedure that allows minimally invasive treatment of abdominopelvic abscesses and fluid collections. This technique has become an alternative for surgery with lower morbility and mortality rates. In this pictorial essay, we aim at providing an overview of the technical approaches, the main clinical indications and complications of CT-guided percutaneous drainage, in order to provide a practical guide for interventional radiologists, with a review of the recent literature. The focus will be the CT-guidance, preferred when the interposition of viscera, vascular and skeletal structures, counteracts the ultrasound guidance.

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Transperitoneal laparoscopic heminephroureterectomy in the pediatric population: A single-centre experience using a sealing device

Canadian Urological Association Journal ◽

10.5489/cuaj.4992 ◽

2018 ◽

Vol 12 (9) ◽

pp. E409-14

Author(s):

Ibrahim Aydogdu ◽

Mesrur Selcuk Silay

Keyword(s):

Minimally Invasive ◽

Pediatric Patients ◽

Pediatric Population ◽

Complication Rates ◽

Retrograde Pyelography ◽

Intraoperative Complication ◽

Single Centre Experience ◽

Invasive Method ◽

Technical Details ◽

Sealing Device

Introduction: We sought to report the outcomes of transperitoneal laparoscopic heminephroureterectomy (LHNU) in a pediatric population and to describe the technical details of this minimally invasive surgery.Methods: Seventeen pediatric patients (18 renal units), who had consecutive transperitoneal LHNU in our department between January 2012 and July 2017 were included in the study. In all patients, diagnostic cystoscopy and retrograde pyelography were carried out immediately before the operation. A catheter was inserted in the unaffected ureter and fixed. LHNU with a transperitoneal approach was carried out in all patients with the aid of LigaSure®. After removal of the specimen, the intervention was finalized with the insertion of a drain. All intraoperative and postoperative data of the patients were recorded prospectively.Results: The average age of the patients was 55.9±35.8 months (range 8–121). The average duration of the operations was 121.7±24.0 minutes (range 100–200). The average hospitalization time was 1.6±0.4 days (range 1–2). No intraoperative complication occurred in our patients. The average followup period was 29.1±13.4 months (range 4–48). During the followup period, no complications were observed except one patient who had pyelonephritis within the first month of surgery.Conclusions: Transperitoneal LHNU is a minimally invasive method that can be used safely in pediatric patients. Using a standardized technique during the procedure is critical to increase the success and decrease the complication rates.

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Proximal Femoral Nail - A Minimally Invasive Method for Stabilization of Subtrochanteric Femoral Fractures

International Journal of Scientific Research ◽

10.15373/22778179/jan2014/178 ◽

2012 ◽

Vol 3 (1) ◽

pp. 20-22

Author(s):

Dr. Dhaval J Patel ◽

◽

Dr. Bipin B Chhajed ◽

Dr. Dhaval R Modi ◽

Dr. Nirav P Trivedi ◽

...

Keyword(s):

Minimally Invasive ◽

Femoral Fractures ◽

Proximal Femoral Nail ◽

Femoral Nail ◽

Invasive Method

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Lumbar periarticular cysts of arcorray joint

Vestnik nevrologii, psihiatrii i nejrohirurgii (Bulletin of Neurology, Psychiatry and Neurosurgery) ◽

10.33920/med-01-2003-06 ◽

2020 ◽

pp. 47-57

Author(s):

Anton Yarikov ◽

Maxim Shpagin ◽

Iliya Nazmeev ◽

Sergey Gorelov ◽

Olga Perlmutter

Keyword(s):

Minimally Invasive ◽

Severe Pain ◽

Pain Syndrome ◽

Long Term Results ◽

Lumbar Region ◽

Results Of Treatment ◽

Invasive Method ◽

Facet Syndrome

The immediate and long-term results of treatment of 30 patients with severe pain syndrome of the lumbar region, who underwent operations on denervation of DOS, were studied. The aim of the study was to evaluate the effectiveness of minimally invasive technologies for the treatment of pain in the lumbar region (denervation of DOS), to study the near and distant results of these treatment methods. Denervation DOS is an effective minimally invasive method for the treatment of facet syndrome caused by spondylarthrosis. It allows in the early and distant postoperative periods to significantly reduce the pain syndrome and improve the quality of life of patients.

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Endoscopic treatment of suprasellar cysts without hydrocephalus

Journal of Neurosurgery Pediatrics ◽

10.3171/2016.4.peds15695 ◽

2016 ◽

Vol 18 (4) ◽

pp. 434-441 ◽

Cited By ~ 8

Author(s):

Song-Bai Gui ◽

Sheng-Yuan Yu ◽

Lei Cao ◽

Ji-wei Bai ◽

Xin-Sheng Wang ◽

...

Keyword(s):

Surgical Technique ◽

Success Rate ◽

Patient Outcomes ◽

Endoscopic Treatment ◽

Foramen Of Monro ◽

Image Guided ◽

Operative Complications ◽

Appropriate Therapy ◽

Endoscopic Fenestration

OBJECTIVE At present, endoscopic treatment is advised as the first procedure in cases of suprasellar arachnoid cysts (SSCs) with hydrocephalus. However, the appropriate therapy for SSCs without hydrocephalus has not been fully determined yet because such cases are very rare and because it is usually difficult to perform the neuroendoscopic procedure in patients without ventriculomegaly given difficulties with ventricular cannulation and the narrow foramen of Monro. The purpose of this study was to find out the value of navigation-guided neuroendoscopic ventriculocystocisternostomy (VCC) for SSCs without lateral ventriculomegaly. METHODS Five consecutive patients with SSC without hydrocephalus were surgically treated using endoscopic fenestration (VCC) guided by navigation between March 2014 and November 2015. The surgical technique, success rate, and patient outcomes were assessed and compared with those from hydrocephalic patients managed in a similar fashion. RESULTS The small ventricles were successfully cannulated using navigational tracking, and the VCC was accomplished in all patients. There were no operative complications related to the endoscopic procedure. In all patients the SSC decreased in size and symptoms improved postoperatively (mean follow-up 10.4 months). CONCLUSIONS Endoscopic VCC can be performed as an effective, safe, and simple treatment option by using intraoperative image-based neuronavigation in SSC patients without hydrocephalus. The image-guided neuroendoscopic procedure improved the accuracy of the endoscopic approach and minimized brain trauma. The absence of hydrocephalus in patients with SSC may not be a contraindication to endoscopic treatment.

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Minimally invasive debridement and drainage using intraoperative CT-Guide in multilevel spondylodiscitis: a long‐term follow‐up study

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-03988-1 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jianbiao Xu ◽

Leiming Zhang ◽

Rongqiang Bu ◽

Yankang Liu ◽

Kai-Uwe Lewandrowski ◽

...

Keyword(s):

Minimally Invasive ◽

Clinical Manifestations ◽

Operation Time ◽

Intervertebral Discs ◽

Intraoperative Ct ◽

Long Term Follow Up ◽

Invasive Method ◽

Vertebral Bodies ◽

Adjacent Segments

Abstract Background Spondylodiscitis is an unusual infectious disease, which usually originates as a pathogenic infection of intervertebral discs and then spreads to neighboring vertebral bodies. The objective of this study is to evaluate percutaneous debridement and drainage using intraoperative CT-Guide in multilevel spondylodiscitis. Methods From January 2002 to May 2017, 23 patients with multilevel spondylodiscitis were treated with minimally invasive debridement and drainage procedures in our department. The clinical manifestations, evolution, and minimally invasive debridement and drainage treatment of this refractory vertebral infection were investigated. Results Of the enrolled patients, the operation time ranged from 30 minutes to 124 minutes every level with an average of 48 minutes. Intraoperative hemorrhage was minimal. The postoperative follow-up period ranged from 12 months to 6.5 years with an average of 3.7 years. There was no reactivation of infection in the treated vertebral segment during follow-up, but two patients with fungal spinal infection continued to progress by affecting adjacent segments prior to final resolution. According to the classification system of Macnab, one patient had a good outcome at the final follow-up, and the rest were excellent. Conclusions Minimally invasive percutaneous debridement and irrigation using intraoperative CT-Guide is an effective minimally invasive method for the treatment of multilevel spondylodiscitis.

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Utility of current sialendoscopes in the sinonasal cavity

The Journal of Laryngology & Otology ◽

10.1017/s0022215115001802 ◽

2015 ◽

Vol 129 (9) ◽

pp. 870-873

Author(s):

C R Kieliszak ◽

T R Khoury ◽

A Singh ◽

A S Joshi

Keyword(s):

Drug Delivery ◽

Minimally Invasive ◽

Paranasal Sinuses ◽

Sphenoid Sinus ◽

Mucosal Biopsy ◽

Before And After ◽

Invasive Method ◽

Cannulation Success ◽

Cadaveric Model ◽

Sphenoid Sinuses

AbstractObjectives:This study assessed the utility of current sialendoscopes in the paranasal sinuses in a cadaveric model and evaluated novel uses for sialendoscopes.Methods:Currently available sialendoscopes were used for visualisation and performing interventions in the paranasal sinuses. Ten cadaver heads were studied before and after dissection. Outcomes included ostia identification, sinus cannulation, success of mucosal biopsy collection and image clarity.Results:Marchal and Erlangen sialendoscopes were found to be effective for both visualising and cannulating the sphenoid sinuses before and after dissection. Both types demonstrated poor maxillary ostia visualisation without dissection, but did allow treatment after antrostomy. Larger diameter sialendoscopes were associated with the lowest image distortion during maxillary ostia assessment. Mucosal biopsy collection within the sphenoid sinus, but not in the maxillary sinus, was possible before dissection.Conclusion:Sialendoscopes can be used for visualisation and performing interventions in the sinonasal cavity, but their utility is mainly limited to the sphenoid sinus. They may be considered a minimally invasive method for drug delivery and/or biopsy collection in the post-operative setting for all sinuses. Design improvements are suggested.

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