Special Pediatric Surgery Forums

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July 30, 20251 yr

Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "To improve the efficacy of the antireflux mechanism, we suggest the following parameters: (a) suture the anastomotic line not only to the mucosa but also to the detrusor muscle to avoid excessive traction on the bladder mucosa; (b) suture the bladder to the abdominal wall, if the surgeon observes excessive traction; and (c) if it is possible according to the mesentery axes, the choice of the apex of the appendix for the bladder anastomosis would be easier to incorporate on the tunnel than the base of the appendix."

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July 30, 20251 yr

Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "It was found that neonatal valve ablation would protect the bladder functions and allow normal bladder cycling and healing. This underscores the importance of routine prenatal screening and early intervention for the valves. These findings suggest that the long-term prognosis of PUV might be improved by prenatal diagnosis [6, 14]." Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "The management of children with PUV is a continuous process that starts …

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July 30, 20251 yr

Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "Irrigation fluid—water if monopolar diathermy is used, saline if bipolar electrocautery" Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "Introduction of bipolar electroresection is reported to allow TUR in saline and to minimize the risk of the obturator reflex, which can predispose to bladder perforation [1]."

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July 30, 20251 yr

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July 30, 20251 yr

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July 30, 20251 yr

Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "The main disadvantage of retroperitoneoscopy is that it is not possible to isolate the ureter arriving near the bladder as in laparoscopy. This is a problem because if the indication is VUR, you can leave a long ureteral stump with the risk to have a postoperative reflux with UTI and the risk to have a second procedure to remove the stump."

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July 30, 20251 yr

Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "According to recommendations from the European Association of Urology and the American Urological Association, we decided to operate on children with VUR grade III or more, with renal dysfunction (DMSA < 40%) or renal scarring demonstrated on isotope renography, and children developing recurrent pyelonephritis despite optimal medical treatment."

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July 30, 20251 yr

Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns - "Catheter occlusions secondary to fibrin or blood clot can be managed with tissue plasminogen activator (TPA). Two milligrams of TPA reconstituted in 40 cc of normal saline, and instilled in the catheter for 1 h, resulted in restoration of patency in 57 % of catheters [26]. Another technique described is the use of an endoscopic retrograde cholangiopancreatography cytology brush to manipulate a malfunctioning PD catheter, with subsequent flushing of the catheter with heparinized saline through the injection port to remove any clot or fibrin." Qu…

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July 30, 20251 yr