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A Colour Atlas of Pediatric Laparoscopic Surgery
Sanjay Oak, Sandesh Parelkar, Prakash Agarwal
SECTION 1: INFRASTRUCTURE AND INSTRUMENTATION
1:
Why Minimal Access Surgery in Children
FUTURE FRONTIERS
2:
Equipment and Instrumentation
IMAGING SYSTEM
Problems and Solutions with Imaging and Viewing
Theatre Setup and Monitor Position
Sterilization and Maintenance of Optics and Camera
Instruments and Access
Anatomy
Insufflator
Veress Needle
Cannulae and Trocars
Anchoring Device
HAND INSTRUMENTS
Instruments for Dissection
Instruments for Electrocautery
Instruments for Irrigation and Suction
Laser
STERILIZATION OF LAPAROSCOPIC INSTRUMENTS
Methods of Sterilization
Steam Sterilization
Ethylene Oxide
Low temperature Steam and Formaldehyde
Plasma Sterilization
Chemical Sterilization
Mechanical Instruments
Sterilization—Between Two Cases
Overnight
Optical Instruments—Cleaning
Sterilization-Between Two Cases
Overnight
Electronic Instruments
Tubings
3:
Energy Sources in Minimal Access Surgery
HEMOSTASIS
PHYSICS OF ELECTROSURGERY
TISSUE INJURY AND INFECTION
BOWEL INJURIES
ARGON BEAM COAGULATOR
BIPOLAR ELECTROSURGERY
ULTRASONIC ENERGY
ULTRASONIC CUTTING, COAGULATION AND CAVITATION
Advantages
Disadvantages
SECTION 2: PREPARING FOR LAPAROSCOPY
4:
Anesthesia for Laparoscopy in the Pediatric Patient
PHYSIOLOGIC CHANGES DURING LAPAROSCOPY
Creation of a Pneumoperitoneum
Insufflating Gas
Disadvantage of CO2 for Insufflation
Precautions to be taken before establishing the pneumoperitoneum
INTRA-ABDOMINAL PRESSURE (IAP)
Cardiovascular Effects
Respiratory Effects of Increased IAP
EFFECTS OF PATIENT POSITION
Neurologic Effects
Endocrinologic Effects
Other Physiological Changes
ANESTHETIC MANAGEMENT
Premedication
Induction and Maintenance of Anesthesia
INTRAOPERATIVE MONITORING
MANAGEMENT OF INTRAOPERATIVE COMPLICATIONS
Cardiovascular Complications
Venous Gas Embolus
Hypotension
Hypertension
Dysrhythmias
Pulmonary Complications
Hypoxemia
Hypercarbia/acidosis
Aspiration
Pneumothorax
Pneumomediastinum/Pneumopericardium
IMMEDIATE POSTOPERATIVE CARE
5:
Complications of Laparoscopic Pediatric Surgery
COMPLICATIONS OF PNEUMOPERITONEUM
COMPLICATIONS BECAUSE OF THE USE OF GAS
COMPLICATIONS DURING ACCESS AND INSTRUMENTATION
Bleeding
Port Site Complications
Bleeding
Port Site Herniation
Port Site Metastasis
ELECTROSURGICAL COMPLICATIONS
Visceral Injuries
Bowel Injury
6:
Ergonomics of Pediatric Laparoscopic Surgery
MECHANICAL RESTRICTIONS
VISUAL RESTRICTIONS
EYE TO HAND COORDINATION AND PARADOXICAL MOVEMENT
Ergonomic Rules
Restriction on Freedom of Movement
SECTION 3: LAPAROSCOPY FOR GASTROINTESTINAL SYSTEM
7:
Diagnostic Laparoscopy in Pediatrics
HOW SHOULD ONE PREOPERATIVELY ASSES A CHILD FOR DIAGNOSTIC LAPAROSCOPY?
WHAT ARE THE CURRENT INDICATIONS?
WHAT IS THE TECHNIQUE TO BE FOLLOWED?
LIMITATIONS OF DIAGNOSTIC LAPAROSCOPY
8:
Laparoscopic Appendectomy in Children
ONE PORT LAPAROSCOPIC APPENDECTOMY
TECHNIQUE
Akira Satomi Technique
Philip CHN Technique
Inoue Technique
Why One Port Technique is Possible In children?
Key Point in The Technique
Advantages of One—Port Technique
9:
Laparoscopic Cardiomyotomy for Achalasia Cardia
10:
Laparoscopic Nissen's Fundoplication
AIMS OF SURGERY
Indications
EQUIPMENT AND INSTRUMENTS
TECHNIQUE
POSTOPERATIVE CARE
POINTS OF IMPORTANCE
11:
Laparoscopic Pyloromyotomy
INTRODUCTION
Contraindications
PREOPERATIVE PREPARATION
Theater Setup for Pyloromyotomy
Instruments
TECHNICAL STEPS FOR LAPAROSCOPIC PYLOROMYOTOMY
Difficult Situations Faced During Laparoscopic Pyloromyotomy
POSTOPERATIVE MANAGEMENT
COMPLICATIONS
Advantages of Laparoscopic Pyloromyotomy
Disadvantage of Laparoscopic Pyloromyotomy
Alternative Laparoscopic Technique
12:
Laparoscopic Assisted Operation for Malrotation
13:
Laparoscopic Adhesiolysis
TECHNIQUE
14:
Laparoscopic Treatment of Hirschsprung's Disease
INDICATIONS
PREOPERATIVE EVALUATION AND PREPARATION
Operating Room Layout
Trocar Positioning
Specific Instrumentation
Technique
POSTOPERATIVE CARE
Advantages of Laparoscopic Pull Through
15:
Laparoscopic Treatment of Anorectal Malformation in Infants and Children
INDICATIONS
Operating Room Layout
Trocar Positioning
Specific Instrumentation
Technique
POSTOPERATIVE CARE
Advantages of Laparoscopic Pull through for Arm
16:
Laparoscopic Treatment of Meckel's Diverticulum
17:
Laparoscopic Herniotomy
ANATOMICAL VIEW ONE OBTAINS THROUGH LAPAROSCOPE
Triangle of Doom, Trapezoid of Doom and Square of Doom
Advantages of Laparoscopic Herniotomy
Advantage of Contralateral Groin Exploration in Children
When the Laparoscopic Herniotomy should not be done?
What are the different types of Laparoscopic Herniotomies?
PREOPERATIVE PREPARATIONS
Instruments Required for Laparoscopic Herniotomy
Pressure and Flow rate kept during Laparoscopic Herniotomy
Operative Room Set-up
Technical Aspects of Laparoscopic Herniotomy
Is there any Difference in Repair of Inguinal Hernia in Female Child?
What difficulties one can come across during Laparoscopic Herniotomy?
COMPLICATIONS OF LAPAROSCOPIC HERNIOTOMY
18:
Laparoscopic Cholecystectomy
INDICATIONS
PREOPERATIVE PREPARATION
Operative Technique
Infants
Ages 2-8
Ages 9-21
Technique
Complications of laparoscopic Cholecystectomy
19:
Laparoscopic Splenectomy
INDICATIONS
PREOPERATIVE PREPARATION
Instruments
Position
Trocars (3-5)
Positioning of the Team
Dissection
Extraction of the Spleen
Closure
Postoperative Care
Advantages over open Splenectomy
Disadvantages over open Splenectomy
20:
Laparoscopic Liver Abscess Drainage
21:
Laparoscopic Management of VP Shunt
SECTION 4: LAPAROSCOPY FOR UROGENITAL SYSTEM
22:
Laparoscopic Management of Cryptorchidism
INDICATIONS
SET-UP AND INSTRUMENTS REQUIRED
Diagnostic Laparoscopy
Operative Laparoscopy
POSITION OF THE PATIENT, SURGEONS, SCRUB NURSE AND INSTRUMENTS
AGE FOR LAPAROSCOPIC ORCHIOPEXY
MALE LAPAROSCOPIC PELVIC ANATOMY APPEARANCE THROUGH LAPAROSCOPE
WHAT APPROACHES ARE ADOPTED AS PER THE OBSERVATIONS MADE?
INDICATIONS FOR GONADECTOMY
Gonadectomy
PORT SITES
TWO STAGE STEPHEN-FOWLER REPAIR
ONE STAGE ORCHIOPEXY
23:
Laparoscopic Varicocelectomy
ANATOMY OF TESTICULAR VESSELS
PREOPERATIVE WORKUP
OPERATIVE SETUP FOR SURGERY
INSTRUMENTS REQUIRED FOR PROCEDURE
TECHNICAL ASPECTS
COMPLICATIONS
24:
Transperitoneal Laparoscopic Nephrectomy
INDICATIONS
CONTRAINDICATIONS
EQUIPMENTS AND INSTRUMENTS
PREPARATION
TECHNIQUE
COMPLICATIONS, PROBLEMS AND SOLUTIONS
ADVANTAGES OF LAPAROSCOPIC NEPHRECTOMY
25:
Laparoscopic Adrenalectomy
INTRODUCTION
INDICATIONS
CONTRAINDICATIONS
INSTRUMENTATION
PROCEDURE
Problems
26:
Laparoscopic Management of Ovarian Cysts
VARIOUS TECHNIQUES HAVE BEEN EMPLOYED
27:
Laparoscopic Dismembered Pyeloplasty
PREOPERATIVE EVALUATION
Equipment
PROCEDURE
PROBLEMS AND COMPLICATIONS
SECTION 5: THORACOSCOPY
28:
Diagnostic Thoracoscopy
INSTRUMENTATION
TECHNIQUE
29:
Laparoscopic Assisted CDH Repair
30:
Thoracoscopic TEF Repair
TECHNIQUE
31:
Video Assisted Thoracic Surgery (VATS) in Empyema
PREOPERATIVE PREPARATION FOR VATS
THEATER SETUP FOR VATS
INSTRUMENTATION
TECHNICAL STEPS OF THORACOSCOPIC DECORTICATION
POSTOPERATIVE MANAGEMENT
COMPLICATIONS OF VATS
32:
Thoracoscopic Dorsal Sympathectomy
SECTION 6: RESEARCH
33:
Minimally Invasive Intravesical Ureteric Reimplantation
TECHNIQUE
RESULTS
DISCUSSION
SECTION 7:
Documentation
References and Key Readings
INDEX
TOC
Index
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