Pediatric gastrointestinal surgery
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quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "running the bowel from the ligament of Treitz to the cecum. This is done more ergonomically by using two working ports and two monitors as shown in Fig. 30.1. The first half of the running should be done looking to the monitor on the left at the top of the patient, and the second half the surgeon has to switch places to the left of the patient and look to the other monitor usually moving to the patient’s lower body. It is important when running the bowel to visualize both sides of the bowel and the mesentery."
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Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "Patient selection is very important and should be a joint decision from a MDT consisting of paediatrician, surgeon, dietician and psychologist. Before decision-making, patients are thoroughly investigated to identify any underlying condition causing obesity, e.g. hypothyroidism or Prader-Willi syndrome (PWS). Investigations also look for any obesity-related co-morbidities. Blood investigations include full blood count, urea and electrolytes, liver function and metabolic profile to look for non-alcoholic hepatic steatosis or type 2 diabete…
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Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns - "The advantages of this technique are preservation of the pylorus, which prevents the dumping syndrome prevalent in bypass, reduced malabsorption (although nutritional deficiencies remain a challenge), relative simplicity and shorter operative time versus bypass, and fewer postoperative complications than bypass, as there is only one staple line and no new spaces are created for internal hernia. Although weight loss is slightly less than that after bypass, a sleeve can later be converted to bypass if the malabsorptive component is later necessar…
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Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns - "The assistant should grasp and laterally retract the posterior wall of the stomach near the greater curvature to ensure no wall of the stomach is folded on itself causing four layers to be included in the staple line. This also prevents the sleeve from twisting as sequential firings take place, resulting in a spiral staple line." Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns - "Anastomotic leakage and bleeding may present initially only as sustained tachycardia; the…
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