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

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.

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

2011 ◽  
Vol 1 ◽  
pp. 31 ◽  
Author(s):  
Keerthi Arani ◽  
Kiran Nandalur ◽  
Christina M Tucker ◽  
David A Bloom
Keyword(s):  
Minimally Invasive ◽  
Patient Outcomes ◽  
Percutaneous Drainage ◽  
Pediatric Population ◽  
Infectious Complications ◽  
Image Guided ◽  
Pictorial Essay ◽  
Invasive Method ◽  
Patient Preparation ◽  
The Common

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.

Epilepsy Surgery of the Temporal Lobe in Pediatric Population: A Retrospective Analysis

Neurosurgery ◽  
2011 ◽  
Vol 70 (3) ◽  
pp. 684-692 ◽  
Author(s):  
Miguel Angel Lopez-Gonzalez ◽  
Jorge Alvaro Gonzalez-Martinez ◽  
Lara Jehi ◽  
Prakash Kotagal ◽  
Ann Warbel ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Epilepsy Surgery ◽  
Pediatric Patients ◽  
Hippocampal Sclerosis ◽  
Pediatric Population ◽  
Cleveland Clinic ◽  
Seizure Freedom ◽  
Complication Rates ◽  
Long Term Outcome

Abstract Background: There is still some reluctance to refer pediatric patients for epilepsy surgery, despite evidence of success in retrospective series. Objective: To describe surgical experience and long-term outcome in pediatric temporal lobe epilepsy (TLE) at a single institution. Methods: Retrospective review of pediatric (<18-years-old) TLE patients who underwent surgery between November 1996 and December 2006 at Cleveland Clinic Epilepsy Center. Cox proportional hazard modeling was used to assess outcome predictors. Results: One hundred thirty pediatric patients met study criteria. Mean time between seizure onset and surgery was 6.3 years. Invasive evaluation was used in 32 patients (24.5%). Hippocampal sclerosis was present in 70 patients (53.8%), either alone or associated in dual pathology. The complication rate was 7%. The seizure-freedom rates at 1, 2, 5, and 12 years were 76%, 72%, 54%, and 41%, respectively (Kaplan-Meier). With the use of the Engel outcome classification, 98 (75.3%) patients were class I, 11 (8.5%) class II, 9 (7%) class III, and 12 (9.2%) were class IV at last follow-up. Only 4 (3.1%) patients underwent reoperations. Antiepileptic drugs (AEDs) were discontinued in 36 patients (28.3%) in a mean period of 18 months (SD ± 17 months; range, 6-102 months). Although left-sided resection, lower number of preoperative AED trials (≤4), and tumor pathology correlated with favorable seizure outcomes, extensive surgical resection remained the only significant outcome predictor after multivariate analysis (P = .007; HR = 0.13 [95% confidence interval 0.007–0.64]). Conclusion: Careful selection of surgical candidates by multidisciplinary evaluations is required. Long-term seizure control is achieved successfully with acceptable low complication rates.

scholarly journals Pediatric Thyroid Cancer: To Whom Do You Send the Referral?

Cancers ◽  
2021 ◽  
Vol 13 (17) ◽  
pp. 4416
Author(s):  
Allison Keane ◽  
Darrin V. Bann ◽  
Meghan N. Wilson ◽  
David Goldenberg
Keyword(s):  
Thyroid Cancer ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
High Volume ◽  
Complication Rates ◽  
Comprehensive Literature Review ◽  
Lower Complication ◽  
General Surgeons ◽  
Definition Of ◽  
Pediatric Thyroid Cancer

Pediatric thyroid cancer is rare, but increasing in annual incidence. Differentiated thyroid cancer in pediatric patients is treated surgically. Pediatric thyroidectomies are performed by general surgeons, otolaryngologists, general pediatric surgeons, and pediatric otolaryngologists. In a comprehensive literature review, we discuss the evidence supporting the importance of surgeon subspecialty and surgeon volume on outcomes for pediatric thyroid cancer patients. Pediatric general surgeons and pediatric otolaryngologists perform most pediatric thyroidectomies. Certain subpopulations specifically benefit from a combined approach of a pediatric surgeon and a high-volume thyroid surgeon. The correlation between high-volume surgeons and lower complication rates in adult thyroid surgery applies to the pediatric population; however, the definition of high-volume for pediatric thyroidectomies requires further investigation. The development of dedicated pediatric thyroid malignancy centers and multidisciplinary or dual-surgeon approaches are advantageous.

Robotic Rectopexy for Rectal Prolapse in Pediatric Patients

2017 ◽  
Vol 83 (12) ◽  
pp. 1386-1389 ◽  
Author(s):  
David J. Hiller ◽  
Jaime L. Bohl ◽  
Kristen A. Zeller
Keyword(s):  
Minimally Invasive ◽  
Rectal Prolapse ◽  
Pediatric Patients ◽  
Pediatric Population ◽  
Short Term ◽  
Invasive Treatment ◽  
Ehlers Danlos Syndrome ◽  
Postoperative Length ◽  
Operative Notes

Rectal prolapse is the protrusion of the rectum out of the anus. Surgical correction can be accomplished via open and minimally invasive abdominal approaches, as well as from the perineum. Robotic rectopexy is an option for minimally invasive treatment of rectal prolapse. There are no studies that have established the efficacy of robotic rectopexy for rectal prolapse in the pediatric population. The aim of this study was to review the experience of robotic rectopexy at a single institution. This is a retrospective review of our pediatric robotic rectopexy experience from 2012 to 2015. Information was obtained from chart review of both operative notes and clinic visits. Four pediatric patients underwent a robotic rectopexy for rectal prolapse from 2012 to 2015. Three patients were male and one was female. The mean age was 15.5 years (range 13–17). Two patients had rectal prolapse with chronic constipation. One patient had rectal prolapse from Ehlers Danlos syndrome, and the last had rectal prolapse after imperforate anus repair as an infant. Three patients received a bowel preparation. Three patients were completed robotically, and one patient required conversion to an open procedure. The average postoperative length of stay was 3.25 days (range 2–4). There were no episodes of recurrent prolapse. Two patients had improvement in constipation, one had no improvement, and one had no documented change. Average postoperative follow-up was 11.5 months (range 3–29). This study was a review of one institution's experience with pediatric robotic rectopexy. With short-term follow-up, there was no recurrence of prolapse. Robotic rectopexy provided a safe, reliable, and short-term resolution of rectal prolapse in pediatric patients.

scholarly journals Linear oblique craniectomy: A novel method of minimally invasive subdural grid insertion

2020 ◽  
Vol 4 (2) ◽  
pp. 2514183X2097308
Author(s):  
Calvin W Howard ◽  
Nader S Aboelnazar ◽  
Noor Salem ◽  
Naweed Syed ◽  
Lian Willetts
Keyword(s):  
Minimally Invasive ◽  
Traditional Approach ◽  
Brain Activity ◽  
Sylvian Fissure ◽  
Complication Rates ◽  
Temporal Epilepsy ◽  
Fresh Frozen ◽  
Human Cadavers ◽  
Invasive Method ◽  
Novel Method

Background: Many countries rely upon subdural grid electroencephalography in the planning of epilepsy surgeries. However, craniotomy for subdural grid implantation is known to result in a variety of complications and requires diligence from the surgical team. We describe a minimally invasive method of subdural grid insertion, termed the linear oblique craniectomy, designed to mitigate complications and increase ease of subdural grid insertion. Objective: To demonstrate feasibility of minimally invasive subdural grid insertion utilizing skull anatomy. Methods: Three fresh frozen and embalmed human cadavers underwent surface landmarking and craniectomy to introduce a 4 × 5 cm2 subdural grid over the Sylvian fissure. Anteroposterior lens-shaped craniectomy measured 5 cm in length with 1 cm maximal width. The dura mater was longitudinally incised, and subdural grids were introduced over the Sylvian fissure. Results: The total area of the craniectomy created by the linear oblique approach consists of only approximately 20% of the total area removed by the traditional approach to access the Sylvian fissure for mesial temporal epilepsy monitoring/preoperative planning. The locations of the grids were evaluated by MRI and computed tomography scans postoperatively to ensure accurate alignment with the Sylvian fissure. Conclusion: In this cadaveric study, we demonstrate the linear oblique craniectomy procedure that provides an alternative approach to subdural grid implantation with significantly decreased invasiveness. This surgical approach has the potential of reducing complication rates of subdural grid insertion for surface monitoring of the brain activity and/or neuromachine interface analysis and is associated with significant reduction of surgical time.

scholarly journals Early outcomes of stereoelectroencephalography followed by MR-guided laser interstitial thermal therapy: a paradigm for minimally invasive epilepsy surgery

2018 ◽  
Vol 45 (3) ◽  
pp. E8 ◽  
Author(s):  
Kelsey Cobourn ◽  
Islam Fayed ◽  
Robert F. Keating ◽  
Chima O. Oluigbo
Keyword(s):  
Minimally Invasive ◽  
Pediatric Patients ◽  
Focal Cortical Dysplasia ◽  
Pediatric Population ◽  
Outcome Data ◽  
Thermal Therapy ◽  
Laser Interstitial Thermal Therapy ◽  
The Mean ◽  
Seizure Foci

OBJECTIVEStereoelectroencephalography (sEEG) and MR-guided laser interstitial thermal therapy (MRgLITT) have both emerged as minimally invasive alternatives to open surgery for the localization and treatment of medically refractory lesional epilepsy. Although some data are available about the use of these procedures individually, reports are almost nonexistent on their use in conjunction. The authors’ aim was to report early outcomes regarding efficacy and safety of sEEG followed by MRgLITT for localization and ablation of seizure foci in the pediatric population with medically refractory lesional epilepsy.METHODSA single-center retrospective review of pediatric patients who underwent sEEG followed by MRgLITT procedures was performed. Demographic, intraoperative, and outcome data were compiled and analyzed.RESULTSFour pediatric patients with 9 total lesions underwent sEEG followed by MRgLITT procedures between January and September 2017. The mean age at surgery was 10.75 (range 2–21) years. Two patients had tuberous sclerosis and 2 had focal cortical dysplasia. Methods of stereotaxy consisted of BrainLab VarioGuide and ROSA robotic guidance, with successful localization of seizure foci in all cases. The sEEG procedure length averaged 153 (range 67–235) minutes, with a mean of 6 (range 4–8) electrodes and 56 (range 18–84) contacts per patient. The MRgLITT procedure length averaged 223 (range 179–252) minutes. The mean duration of monitoring was 6 (range 4–8) days, and the mean total hospital stay was 8 (range 5–11) days. Over a mean follow-up duration of 9.3 (range 5.1–16) months, 3 patients were seizure free (Engel class I, 75%), and 1 patient saw significant improvement in seizure frequency (Engel class II, 25%). There were no complications.CONCLUSIONSThese early data demonstrate that sEEG followed by MRgLITT can be used safely and effectively to localize and ablate epileptogenic foci in a minimally invasive paradigm for treatment of medically refractory lesional epilepsy in pediatric populations. Continued collection of data with extended follow-up is needed.

Surgical Technique: Papillary Muscle Sling for Functional Mitral Regurgitation during Minimally Invasive Valve Surgery

2013 ◽  
Vol 16 (5) ◽  
pp. E295-E297 ◽  
Author(s):  
Joseph Lamelas ◽  
Christos Mihos ◽  
Orlando Santana
Keyword(s):  
Mitral Regurgitation ◽  
Minimally Invasive ◽  
Median Sternotomy ◽  
Rational Approach ◽  
Functional Mitral Regurgitation ◽  
Minimally Invasive Approach ◽  
Invasive Approach ◽  
Mitral Annuloplasty ◽  
Technical Details ◽  
Mitral Apparatus

In patients with functional mitral regurgitation, the placement of a sling encircling both papillary muscles in conjunction with mitral annuloplasty appears to be a rational approach for surgical correction, because it addresses both the mitral valve and the deformities of the subvalvular mitral apparatus. Reports in the literature that describe the utilization of this technique are few, and mainly involve a median sternotomy approach. The purpose of this communication is to describe the technical details of performing this procedure via a minimally invasive approach.

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

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

Lumbar periarticular cysts of arcorray joint

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.

scholarly journals Safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy in the management of renal stones ≤ 2 cm: a single-center experience

2019 ◽  
Vol 25 (1) ◽  
Author(s):  
Elsayed M. Salih ◽  
Ibrahim Elsotohi ◽  
Hisham Elhelaly ◽  
Mohamed Elsalhy ◽  
Mourad M. Mourad
Keyword(s):  
Minimally Invasive ◽  
Percutaneous Nephrolithotomy ◽  
Renal Stone ◽  
Renal Stones ◽  
Stone Size ◽  
Intraoperative Complication ◽  
Safety And Efficacy ◽  
Single Center Experience ◽  
Minimally Invasive Percutaneous Nephrolithotomy ◽  
The Mean

Abstract Background The goal for using smaller caliber instruments in PNL was to reduce the access-related complications and to decrease morbidity. The objective of this study was to evaluate the safety and efficacy of Chinese minimally invasive percutaneous nephrolithotomy (MIPNL) in the treatment of renal stones ≤ 20 mm. Results Sixty-seven patients completed the study protocol. The mean age was 41.10 ± 13.99 years (range 18–68 years). There were 43 (64%) male and 24 (36%) females. The mean stone size was ranged from 78.5 to 439.6 mm2 (mean ± SD 172.48 ± 69.54 mm2). The overall SFR was (82%). Twelve (18%) needed post-MIPNL auxiliary procedure, in the form of second MIPNL in 3 (4.5%) cases, SWL in 7 (10%), and RIRS in 2 (3%) cases. The intraoperative complication was present in four patients (5%) include bleeding necessitate blood transfusion in one patient (1.5%) and renal collecting system perforation 3 (4.5%). The postoperative complication was urine leakage 5 (7.5) and fever in 6 (9%) of patients. Conclusion Chinese MIPNL is safe and effective method for treatment of renal stone ≤ 20 mm size with satisfactory SFR and low complication rate when SWL failed or contraindicated. It is considered a feasible treatment alternative to standard PNL, in the absence of flexible URS or miniature nephroscope.

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