ABSTRACT
AIMS: To retrospectively analyse the results of laparoscopically-assisted anorectal pull-through (LAARP) for high anorectal malformation (ARM) in male children in our institution. MATERIALS AND METHODS: We analysed the hospital records of patients who had undergone LAARP from October 2010 to December 2015 in terms of age, operative time, length of hospital stay and post-operative complications. RESULTS: Of 17 cases, 13 (76%) were in 6-12 months age group, whereas rest of them were in 12-18 months age group. The recto-prostatic urethral fistula was encountered in 82% (n = 14) of patients and rectovesical type in two cases (12%). The mean operative time was 132 min with mean length of hospital stay being 4 days. Rectal mucosal prolapse was the most common complication noted. CONCLUSIONS: LAARP is a feasible approach to male children with high ARMs with less post-operative morbidity.
ABSTRACT
BACKGROUND: Subcutaneous endoscopic excision of benign lesions of the head, neck and trunk is a new dimension in paediatric minimally invasive surgery. This study is a case series where cases are operated endoscopically with minimal scars. PATIENTS AND METHODS: This is a prospective study where in 13 patients who underwent Stealth surgery were enrolled in this study. Factors such as intraoperative time, blood loss, intraoperative complications, postoperative recovery and appearance and placing of minimal scars at inconspicuous sites were taken into consideration. RESULTS: All patients underwent successful surgery without converting to open surgery. Out of 13 patients, five were torticollis, four were suprasternal dermoid, one had chest wall swelling, one had swelling of arm, one had back lipoma and one had forehead lipoma. The mean operation time was 50 min (range 32-70). All patients were followed up regularly postoperatively. All patients were operated as daycare, less postoperative pain, no evident scars, lower complications related to scars. CONCLUSION: Subcutaneous endoscopic surgery addresses concerns related to scarring by replacing large visible incisions with smaller incisions placed in inconspicuous locations. This is a safe and effective procedure of early recovery.
ABSTRACT
Testicular tumour in an intra-abdominal undescended testis is a rare finding. We report a case of mature teratoma in an intra-abdominal testis of a 4-year-old boy. He presented with nonpalpable testis on the right side. Abdominal ultrasound was normal. Diagnostic laparoscopy revealed a large tumour arising from an intra-abdominal right testis, and histologic analysis identified a mature teratoma. The tumour was completely removed laparoscopically, and there was no recurrence at follow-up 1 year later.
ABSTRACT
AIM: The aim of this paper is to study the outcome of day case laparoscopic cholecystectomy (DCLC) in children. MATERIALS AND METHODS: A clinical pathway for day care laparoscopic cholecystectomy was followed with emphasis on the analgesia, post-operative nausea and vomiting (PONV), feeding, mobilization, pain scoring and patient satisfaction. Demographic and clinical data were recorded prospectively from March 2013 to November 2013. The setup allowed easy access to an overnight stay if needed. Hospital stay, complications, the need for medical advice after discharge, convalescence and patients satisfaction were analyzed. RESULTS: We admitted 11 children with symptomatic cholelithiasis for day case laparoscopic surgery. There were no intra- or post-operative complications. The incidence of PONV was 0/11. There was no readmission. 4/11 patients complained of shoulder tip pain on follow-up next day. There was no overnight stay. CONCLUSIONS: Adoption of a DCLC pathway is feasible and safe for children. Emphasis on adequate pain management and avoidance of PONV results in a high rate of day case surgery equivalent to that achieved in adult practice.
ABSTRACT
Laparoscopic management in a case of congenital urethroanal fistula with a normal anterior urethra in a 5-month-old male child is reported. A congenital H-type urethroanal fistula is a rare entity. Management of such fistula has always been surgical, ranging from perineal dissection, posterior saggital approach, to abdomino-perineal approach. We describe a minimally invasive laparoscopic method for approaching such fistula, which has not been described in the literature and is being reported for the first time.
