Administration of Nitrous Oxide by Medical Assistants for Painful Procedures in Outpatient Pediatric Settings.

Background: Managing pain and distress in children experiencing procedural pain is a priority in pediatric care. Nitrous oxide (pre-mixed formulation of 50% nitrous oxide to 50% oxygen) is widely used to alleviate anxiety or pain during care procedures in various medical domains. This pharmacological intervention is safe to administer to children.

Shear fractures of the capitellum in children: a case report and narrative review.

The shear fractures of the capitellum are rare fractures in the pediatric population. Their diagnosis is challenging because of the high cartilaginous component of the growing elbow, requiring a high level of clinical suspicion especially in the case of small osteochondral or chondral fragments. The literature on capitellar shear fractures is mainly represented by case reports, which provides a patchy view of the topic.

Narrative review in learning curve and pediatric robotic training program.

Background And Objective: Studying learning curve (LC) for robotic procedures and developing an adequate training program are two fundamental steps to standardize robotic procedures. With this aim, we analyzed the literature to study the LCs of different robotic procedures and the availability of standardized training problems.

Methods: The PubMed database was searched in the period from January 1995 to September 2022.

Fluids and body composition during anesthesia in children and adolescents: A pilot study.

The purpose of this study is to evaluate the intracellular and extracellular volume before and after anesthesia in order to ascertain their variations and determine the potential utility of this information in optimizing intraoperative fluid administration practices. A bioimpedance spectroscopy device (body composition monitor, BCM) was used to measure total body fluid volume, extracellular volume, and intracellular volume. BCM measurements were performed before and after general anesthesia in unselected healthy children and adolescents visiting the Pediatric Institute of Southern Switzerland for low-risk surgical procedures hydrated with an isotonic solution.

Robotic-assisted surgery for gynecological indications in children and adolescents: European multicenter report.

Robotic-assisted surgery (RAS) is increasingly adopted in the pediatric population. This retrospective multicenter study aimed to report application of RAS for gynecological indications in pediatric patients. The medical records of all girls with gynecological pathology, operated in 4 different institutions over a 3-year period, were retrospectively collected.

Pediatric endoscopic pilonidal sinus treatment (PEPSiT): report of a multicentric national study on 294 patients.

This study aimed to report a multicentric national experience about the outcomes of pediatric endoscopic pilonidal sinus treatment (PEPSiT). The medical records of all pediatric patients, aged up to 18 years, who underwent PEPSiT in the period 2019-2021, were retrospectively reviewed. Patients' demographics, operative details, and post-operative outcomes were assessed.

Robotic Surgery in Pediatric Urology: A Critical Appraisal of the GECI and SIVI Consensus of European Experts.

This study aimed to create a consensus statement on the indications, applications, and limitations of robotics in pediatric urology. After a panel and interactive discussion focused on pediatric robotics, a televoting with 10 questions was administered to 100 pediatric surgeons/urologists attending the joint meeting of the French Group of Pediatric Laparoscopy (GECI)/Italian Society of Videosurgery in Infancy (SIVI) in 2021. The results of televoting were analyzed electronically using Mentometer software.

Pediatric endoscopic pilonidal sinus treatment (PEPSiT): what we learned after a 3-year experience in the pediatric population.

This paper aimed to report a multi-institutional 3-year experience with pediatric endoscopic pilonidal sinus treatment (PEPSiT) and describe tips and tricks of the technique. We retrospectively reviewed all patients < 18 years, with primary or recurrent pilonidal sinus disease (PSD), undergoing PEPSiT in the period 2017-2020. All patients received pre-operative laser therapy, PEPSiT and post-operative dressing and laser therapy.

Comparison of the Learning Curve for Robot-Assisted Laparoscopic Pyeloplasty Between Senior and Junior Surgeons.

The widespread use of robotic surgery has provided surgeons a high-quality and alternative method to perform pyeloplasty. Indeed, robot-assisted technology has made it a lot easier to obtain the advanced technical skills required to perform this procedure. The learning curve (LC) reflects the increase in learning as a function of experience.

Pediatric Endoscopic Pilonidal Sinus Treatment (PEPSiT) in Children With Pilonidal Sinus Disease: Tips and Tricks and New Structurated Protocol.

The advent of pediatric endoscopic pilonidal sinus treatment (PEPSiT) has dramatically changed the surgical management of pilonidal sinus disease (PSD) in children and adolescents. This study aimed to report the outcome of our new structurated protocol, including PEPSiT, laser epilation, and oxygen-enriched oil-based gel dressing, for treatment of PSD in pediatric patients and describe tips and tricks of the technique. We retrospectively reviewed the data of 127 pediatric patients, who underwent PEPSiT for PSD in our institutions over a 36-month period.

Management of COVID-19-Positive Pediatric Patients Undergoing Minimally Invasive Surgical Procedures: Systematic Review and Recommendations of the Board of European Society of Pediatric Endoscopic Surgeons.

Hospital response to the COVID-19 outbreak has involved the cancellation of elective, deferrable surgeries throughout Europe in order to ensure capacity for emergent surgery and a selection of elective but non-deferrable surgeries. The purpose of this document is to propose technical strategies to assist the pediatric surgeons to minimize the potential aerosolization of viral particles in COVID-19 patients undergoing urgent or emergent surgical treatment using laparoscopic approaches, based on the currently available literature. The situation and recommendations are subject to change with emerging information.

Treatment of paediatric unstable displaced distal radius fractures using Kapandji technique: a case series.

Background: The technique of intra-focal pinning described by Kapandji is seldom used in paediatric patients. We present our series of paediatric patients treated with Kapandji technique for unstable displaced distal radius fractures.

Methods: We retrospectively reviewed medical records and radiographs of a consecutive series of 56 paediatric patients who underwent closed reduction and fixation with Kapandji technique for unstable displaced metaphyseal and Salter Harris 2 distal radius fractures, from 2008 to March 2018.

Osteochondral flap fracture of the coronoid in pediatric elbow dislocation: a case report and literature review.

Osteochondral flap fractures of the coronoid are rare occult fractures, often diagnosed in delay, in pediatric patients who underwent elbow dislocations. Only 11 pediatric cases of osteochondral flap fractures of the coronoid are described in the literature. We describe a pediatric case treated in our institution for an elbow dislocation accompanied by a triad of elbow fractures, including the osteochondral flap fracture of the coronoid, and review available literature on the osteochondral flap fracture of the coronoid in pediatric patients.

Pediatric Posterior Cruciate Ligament Avulsion Fracture of the Tibial Insertion: Case Report and Review of the Literature.

 Posterior cruciate ligament (PCL) avulsion fracture of the tibial insertion is a very rare injury in children. In addition to performing an attentive clinical examination, radiologic studies are fundamental for its correct diagnosis and treatment. Its management may be either conservative or operative.

Appendix extraction after laparoscopic appendectomy in children: An easy, safe, and inexpensive technique.

Background: Laparoscopic appendectomy is becoming an increasingly common operation among children. It is well known that the abdominal wall should not be exposed to the appendix's inflamed tissue during its removal. Several ways to protect the retrieval site have been described, with controversial results.

European Society of Pediatric Endoscopic Surgeons (ESPES) guidelines for training program in pediatric minimally invasive surgery.

Purpose: The aim of this paper was to propose structured guidelines for a European pediatric MIS training program created by ESPES.

Methods: A questionnaire, focused on how the pediatric training program in MIS has to be structured, was proposed to all participants at the ESPES Congress in Marseille in 2013.

Results: We received 178 questionnaires but only 139 questionnaires were fully completed and analyzed.

Severe systemic adverse reaction to proton pump inhibitors in an infant.

Episodes of respiratory distress with chest retraction and wheezing, sometimes associated with facial edema, were noted after administering the proton pump inhibitors omeprazole and esomeprazole in an infant with gastroesophageal reflux. The disturbances relieved dramatically after withdrawing the proton pump inhibitor.

Gastric volvulus in children.

Purpose: The aim of the study was to review the records of all children who presented with gastric volvulus in the past 10 years.

Methods: The study group consisted of 21 children with an age range from 0.2 months to 4.

New tools for laparoscopic division of the pancreas: a comparative animal study.

We tested the hypothesis that the pancreas can be safely divided laparoscopically using non-suture devices. Twelve pigs were randomized into 4 groups: 1) laparoscopic distal pancreatectomy (LDP) using an ultrasonic scalpel; 2) LDP using an ultrasonic scalpel with pancreatic stump suture reinforcement; 3) LDP using a 35-mm laparoscopic linear vascular stapler; 4) LDP using a prototype 35-mm radio-frequency laparoscopic linear vascular stapler. There were no serious complications related to distal pancreatectomy.

CO2 Pneumoperitoneum modifies the inflammatory response to sepsis.

Objective: To analyze the effect of CO2 pneumoperitoneum on the inflammatory response induced by sepsis during laparoscopy.

Summary Background Data: A growing body of evidence challenges the once generally accepted notion that smaller incisions alone account for the observed benefits of the laparoscopic approach. Furthermore, laparoscopic surgery is now being applied to a broad spectrum of patients, including those in whom the inflammatory response is ignited.

Evaluation of scooter-related injuries in children.

Background/purpose: The sudden popularity of the "scooter phenomenon" was followed by an increased rate of injuries associated with its use. This study evaluates the circumstances, types, degrees, and mechanisms of injury related to the use of a scooter in the pediatric population.

Methods: From January 2000 to February 2001, the emergency files of all the children arriving at the authors' institutions with a diagnosis of "scooter related trauma" were reviewed.

Effect of laparoscopic antireflux surgery upon renal blood flow.

Background: Hypercapnia and local pressure effects unique to CO(2) base minimally invasive surgery alter renal blood flow. We have demonstrated laparoscopic antireflux surgery to have an additional impact upon hemodynamics (decreased cardiac output), potentially extending known effects upon renal blood flow.

Methods: We measured renal blood flow with radioactive microspheres during laparoscopic antireflux surgery in a porcine model.