By A. Smamsa
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Extra info for Advanced Laparoscopy
2007). Bax and van der Zee (2004) reported improved outcome from laparoscopy assisted interruption of the median sacral artery and dissection of the internal component of sacrococcygeal teratomas. Desai et al (2009) reported the ligation of median sacral artery in a premature neonate with a giant sacrococcygeal teratoma achieving minimal blood loss in the remaining part of the surgery. 2 Laparoscopy in trauma Diagnostic laparoscopy is gaining increasing application in paediatric trauma in the stable patient with equivocal clinical parameters not requiring immediate laparotomy but not symptom-free.
It will need to be emptied by expression with gentle compression pressure on the lower abdomen or by use of a urethral catheter. To maximise the space, a nasogastric tube is often inserted and intermittently aspirated to decompress the stomach. Some surgeons give aperients to the children to empty intestinal contents 24 to 48hours before laparoscopic surgery to minimise interference with surgery and optimise the space within the abdominal cavity. The relatively higher body surface/ mass ratio in infants means they have a delicate fluid balance which is easily stressed and put under pressure by evaporation of body fluids from exposure of abdominal contents at laparotomy.
241-8, ISSN 1098-7339 2 Laparoscopy in Children and Infants Ngozi Joy Nwokoma1 and Thomas Tsang2 1Addenbrooke’s 2Norfolk Hospital, Cambridge and Norwich University Hospital United Kingdom 1. Introduction The “first do no harm” ethics of medical care has its age-long influence manifested in the continual search for the least invasive method of administering treatment to the patient. The advancement of the minimally invasive surgery has therefore been a very welcome development in surgical specialities with paediatric surgery not left behind in this quest.
Advanced Laparoscopy by A. Smamsa