A Simulation Model to Support Laparoscopic Pyloromyotomy Teaching.

Introduction: A key concern regarding laparoscopic pyloromyotomy (LP) lies with the process of learning this skill. The learning processes for open pyloromyotomy and LP appear to be different, with an earlier increased risk of perforation or incomplete pyloromyotomy (IP) for LP. Our aim was to develop a simple simulation tool to reduce these specific complications.

Robotic-assisted laparoscopic surgery for pediatric tumors: a bicenter experience.

Mini-invasive surgery is more and more integrated in pediatric surgery. The robotic-assisted surgery brought new advantages from which the patient and the surgeon could benefit compared to laparoscopy. Its use in oncological surgery is still controversial.

Robot-Assisted Laparoscopic Fundoplications in Pediatric Surgery: Experience Review.

Introduction:  Laparoscopic fundoplicature for gastroesophageal reflux disease has become the gold standard because of the improvement of postoperative rehabilitation compared with the open procedure. The robot-assisted surgery has brought new advantages for the patient and the surgeon compared with laparoscopy. We studied this new approach and the learning curve.

Comparison of 8 and 5 mm robotic instruments in small cavities : 5 or 8 mm robotic instruments for small cavities?

Introduction: Robotic surgery has seen increasing use in the field of pediatric surgery. Our clinical experience suggested instrument size can impact on the surgical ability. This study aimed to compare the performance of robot-assisted laparoscopic skills in confined spaces using either 5 or 8 mm instruments.

How robotic-assisted surgery can decrease the risk of mucosal tear during Heller myotomy procedure?

We report the first description of robotic-assisted Heller myotomy in children. The purpose of this study was to improve the safety of Heller myotomy by demonstrating, in two adolescent patients, the contribution of the robot to the different steps of this procedure. Due to the robot's freedom of movement and three-dimensional vision, there was an improvement in the accuracy, a gain in the safety regarding different key-points, decreasing the risk of mucosal perforation associated with this procedure.

Differential learning processes for laparoscopic and open supraumbilical pyloromyotomy.

Purpose: To compare the learning curves for mastering OP and LP surgical techniques, in terms of effects on completion times and postoperative outcomes/complications.

Methods: A retrospective analysis was performed for 198 patients with hypertrophic pyloric stenosis. The learning curves were in regard to two groups of surgeons: three of whom performed 106 OPs while three others performed 92 LPs.

What are the prospects for non-scheduled robotic procedures in pediatric surgery?

Robotic technology allows for the management of complex surgical cases with a minimally invasive approach. The aim of this study was to communicate our experience using robotic technology for non-scheduled pediatric procedures (NSP). We performed a prospective study over the last 5 years including all consecutive cases where surgery was performed with a robot.

A comparison of robotic surgery in children weighing above and below 15.0 kg: size does not affect surgery success.

Background: Initial results in pediatric surgery are encouraging, particularly in the field of pediatric urology. However, there is limited experience with its application in infants and neonates. The aim of this study was to compare the feasibility and safety of robotic-assisted surgery in two populations of children, one weighing less and one weighing more than 15.

Assessment of paediatric thoracic robotic surgery.

Objectives: Many studies have reported that robotic-assisted surgery is safe and feasible for paediatric cases. However, very few paediatric thoracic robotic cases have been described. The aim of this study was to share our preliminary experience with robot-assisted thoracic surgery (RATS).

Neurofibroma and epidermoid cyst: unexpected findings after first foreskin retraction.

We report here 2 unusual cases of tumor of the glans penis in children. Abnormal findings were found on a 12-year-old and a 13-year-old boy soon after their first foreskin retraction. Initial medical examination suggested inclusions of smegma and they were referred to our Department of Pediatric Urology.

How to successfully implement a robotic pediatric surgery program: lessons learned after 96 procedures.

Background: Both our teams were the first to implement pediatric robotic surgery in France. The aim of this study was to define the key points we brought to light so other pediatric teams that want to set up a robotic surgery program will benefit.

Methods: We reviewed the medical records of all children who underwent robotic surgery between Nov 2007 and June 2011 in both departments, including patient data, installation and changes, operative time, hospital stay, intraoperative complications, and postoperative outcome.

Dorsal distal radius fractures in children: role of plaster in redisplacement of these fractures.

The aim of this study was to retrospectively identify the role of plaster in redisplacement of dorsal distal radius fracture in children. A total of 60 children with displaced dorsal distal radius fractures were included in this study. All these fractures were reduced under general anesthesia.

Distal humerus lateral condyle fracture in children: when is the conservative treatment a valid option?

Introduction: Distal humerus condyle fracture in children is rare. These fractures often mislead the emergency physician or surgeon. However, treatment adapted to the degree of displacement achieves excellent clinical and radiographic results.

Dermatofibrosarcoma protuberans in childhood.

Dermatofibrosarcoma protuberans (DFSP) is a rare cutaneous tumor with a possibly misleading presentation. It is rare in childhood. We report an 18-month-old child with an acquired atrophic plaque of the left ankle.

[Value of orthopedic treatment of distal fractures of the forearm in children. Apropos of 152 cases].

Purpose Of The Study: Distal forearm fractures in children are frequent. Management is conservative except in rare cases which will be discussed.

Material And Methods: Retrospective analysis of 152 distal forearm fractures after 10 and a half months (6 to 48 months) of follow-up was carried-out.

Laparoscopic fundoplication in children: our first 30 cases.

We report our experience performing 30 laparoscopic fundoplications in children (24 using the Nissen Rossetti technique and 6 using the Toupet fundoplication). Special instruments adapted to the young children are used: first, a miniature parietal suspender to decrease the intra-abdominal pressure and to provide more space; second, a retractable losenge-shaped liver retractor; and third, a Babcock forceps articulated at 60 degrees. In the Nissen Rossetti procedure, the wrap is fixed to the anterior face of the esophagus, the anterior wall of the fundus, and the upper right crus.

Extramucosal pyloromyotomy by laparoscopy.

Since 1990, we have performed extramucosal pyloromyotomies by laparoscopy in 70 infants presenting with congenital hypertrophic pyloric stenosis. Ever since the first cases, the technique and the instruments have been adapted. The surgical technique and the precautionary measures are here explained again.

[Priapism. Apropos of a case in a 10-year old child].

We report a case of post-trauma priapism observed in a 10-year old boy. Arterial blood flow was high with normal venous backflow, an exceptional situation in the child. Locoregional caudal anaesthesia was successful.

Monitoring of the motor pathway during spinal surgery.

Paraplegia caused by irreversible lesions of the spinal cord is one of the major possible complications after scoliosis surgery. Several monitoring methods have been proposed but none are completely satisfactory. Since 1986 the authors assessed motor pathways during scoliosis surgery, using electrical stimulation of the motor cortex and lower limb muscle recordings (tibialis anterior muscle).

[Pyloric stenosis in infants. Contribution of ultrasonography and video-surgery].

Hypertrophic pyloric stenosis is the commonest condition requiring abdominal surgery in infancy. The Fredet-Ramstedt pyloromyotomy gives a very rare morbidity rate as shown by a review of 300 personal cases. The diagnostic value of sonography is gaining significance over contrast roentgenography, a pyloric diameter of more than 14 mm and a muscular thickness of more than 4 mm being required for the diagnosis.

[Pyloric stenosis in infants. New surgical approaches].

Pyloromyotomy as described by Fredet and Ramstedt is still widely used for the treatment of infantile hypertrophic pyloric stenosis, with a very low mortality rate. Three hundred case-records of patients treated using this technique were reviewed. Pyloromyotomy can benefit from the use of videosurgical methods.