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Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "After birth there are two scenarios [3]: first is the presence of a complex cyst at ultrasound. The ovary is lost, and surgery will be delayed for several weeks; second is a simple cyst of more than 5 cm. In this case a US-guided transcutaneous evacuating puncture may be tried, or patient is put on the operating table for a punction under laparoscopic control very soon after birth in order to avoid torsion and loss of the ovary [4, 5]."

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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 diabetes. A sleep study should also be performed to diagnose obstructive sleep apnoea. Apart from this, baseline anthropometric measurements, an ECG, echocardiogram, and ambulatory blood pressure monitoring are also performed." Quote from "ESPES Manual of Pediatric Minimally Invasive Surgery" by Ciro Esposito, François Becmeur, Henri Steyaert, Philipp Szavay - "When a patient has been deemed suitable for surgical intervention, a liver shrinking diet is recommended. It comprises of a 14-day period of high-protein, low-carbohydrate milkshake replacement for meals, which aims to reduce weight and size of the liver, making the laparoscopic access to the stomach easier."

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 necessary or if post-sleeve reflux is refractory."

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; therefore, the threshold for obtaining an oral and IV contrast-enhanced CT scan in the early postoperative period should be low." Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns - "Bleeding tends to occur where dissection of the gastroepiploics began, and this area should be inspected prior to removal of ports. Sleeve leaks tend to occur proximally, where visualization of the last staple firing is difficult and the esophagus may be crossed."