Special Pediatric Surgery Forums

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August 4, 20251 yr

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August 4, 20251 yr

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August 4, 20251 yr

Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns - "The diagnosis of HD must be confirmed by an experienced, reliable pathologist with a rectal biopsy. This technique is best suited for short-segment disease, and ideally the patient would have a barium enema study demonstrating a distal transition zone. Longer segment disease is a relative contraindication for this surgical option, and these patients may be better served by a Duhamel procedure l. Prematurity is a relative contraindication, as these patients may not have fully mature ganglion cells and histologic evaluation of biopsies may theref…

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August 4, 20251 yr

Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "compared to totally transanal endorectal pull-through, the Soave-Georgeson technique allows to better assess the colon pedicle tension, to avoid colon twisting, and to perform intraoperative colon biopsies before starting endorectal dissection and mesocolic vessel division."

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August 4, 20251 yr

“Placement of the Stoma Site. The stoma site on the abdominal wall should be placed away from the rib cage because, with the child’s growth, the distance between the two tends to become shorter. A gastric access device that is too close to the ribs will cause discomfort and interfere with care. Additionally, pivoting motion resulting from breathing and moving can lead to stoma enlargement and leakage. In small children, the linea alba tends to be broad and very thin and also should be avoided as an exit site. The stoma site on the stomach should be in the mid-body—away from the greater curvature, because the proximity to the transverse colon can lead to a gastrocolic fist…

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August 4, 20251 yr

This quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns - "Review of the KID data found a 1.67 odds ratio of small bowel resection with operative intervention delayed until hospital day 3–14, and no difference in small bowel resection between operating on day 1 versus day 2. It is recommended that stable patients without concerning signs of perforation, strangulation, or peritonitis can be safely managed conservatively for 48 h in children over 2 years and 24–48 h in children less than 2 years of age [18]. It is crucial that these patients are closely observed for signs of deterioration in either …

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August 4, 20251 yr