Robot-assisted laparoscopic surgery using DROP-IN radioguidance: first-in-human translation.

Purpose: Radioguided surgery has been widely used for clinical procedures such as sentinel node resections. In the (robot-assisted) laparoscopic setting radioguidance is realized using laparoscopic gamma probes, which have limited maneuverability. To increase the rotational freedom, a tethered DROP-IN gamma probe was designed.

Revolutionizing (robot-assisted) laparoscopic gamma tracing using a drop-in gamma probe technology.

In complex (robot-assisted) laparoscopic radioguided surgery procedures, or when low activity lesions are located nearby a high activity background, the limited maneuverability of a laparoscopic gamma probe (LGP; 4 degrees of freedom (DOF)) may hinder lesion identification. We investigated a drop-in gamma probe (DIGP) technology to be inserted via a trocar, after which the laparoscopic surgical tool at hand can pick it up and maneuver it. Phantom experiments showed that distinguishing a low objective from a high background source (1:100 ratio) was only possible with the detector faced >90° from the high background source.

First Robotic SPECT for Minimally Invasive Sentinel Lymph Node Mapping.

In this paper we present the usage of a drop-in gamma probe for intra-operative Single-Photon Emission Computed Tomography (SPECT) imaging in the scope of minimally invasive robot-assisted interventions. The probe is designed to be inserted and reside inside the abdominal cavity during the intervention. It is grasped during the procedure using a robotic laparoscopic gripper enabling full six degrees of freedom handling by the surgeon.

Use of intraperitoneal pressure, ultrafiltration and purification dwell times for individual peritoneal dialysis prescription in children.

Tolerance of peritoneal dialysis is, in a part, dependent on intraperitoneal dialysate volume. Measurement of intraperitoneal pressure (IPP) in cm of water is easy to perform especially with the twin bag Y set (Baxter). Today we use IPP for following surgical catheter implantation (delaying, starting and progressing with peritoneal dialysis) and for optimizing ultrafiltration and purification.

[Role of peritoneal dialysis for the treatment od terminal renal insufficiency in the child].

Peritoneal dialysis (PD) is the most common used method of treatment for end stage renal failure, specially adapted for home dialysis, easily applicable even for infants. PD creates a degree of independence but also of responsibility. PD failed out with time (transfered to hemodialysis) secondary to familial and medical (peritonitis) exhaustions.

[Gitelman syndrome in children: true hypokalemia but false Bartter syndrome].

Background: Gitelman's syndrome or familial hypokalemia-hypomagnesemia and Bartter syndrome share some common features but their prognosis is quite different.

Case Report: Four unrelated children, aged 5 to 12 years, were studied because they suffered from muscle cramps and/or abdominal pain. Supportive findings included: hypokalemia (2.

[Double profile dialysis: ultrafiltration and sodium variable description and clinical validation in the child].

Despite significant technical improvements (bicarbonate dialysate, volumetric ultrafiltration control) high intradialytic ultrafiltration is troublesome in children, specially in the proportion of patients presenting a normal or low blood pressure even with overweight. We used, in this group of children (overhydratated without vascular repercution) a modelling of both sodium and ultrafiltration during dialysis, in order to achieve dry body weight without increasing session time despite hypotension risks. The usefulness and practicability of sodium and ultrafiltration modelling together during dialysis in children is analysed in a short time study (for plasma volume changes calculation) and in a long term follow up study over a year (for clinical tolerance).

Solute equilibration curves, crossing time for urea and glucose during peritoneal dialysis: a function of age in children.

Glucose is absorbed from the dialysate more rapidly in younger than in older children on CAPD leading to a relatively early loss of ultrafiltration during dwell time. In order to assess peritoneal permeability and in term to prescribe optimal management of CAPD, we tested peritoneal equilibration curves (EC) for urea and glucose, especially the crossing time point of these two ECs. Baseline values were obtained from 8 patients divided in two groups by age at start of CAPD: group I (N = 4) mean age 1 year 6 months, mean body weight 8.

Urinary tract infections with tissue penetration in children: cefotaxime compared with amoxycillin/clavulanate.

In children, the site of urinary tract infection (acute pyelonephritis or cystitis) cannot usually be accurately determined from the clinical presentation. The severity of the urinary tract infection (risk of renal scars) is best correlated with its estimated degree of tissue penetration clinically (fever, general condition) and on laboratory tests (sedimentation rate, C-reactive protein). The duration of parenteral antibiotic therapy, especially in children (taking account of difficult venous access and the cost of hospitalization) needs to be specified beyond the initial period required for sterilization of the urine (usually less than 48 h).

[Urinary infections in children].

Urinary tract infection is frequent in childhood, usually without major consequences. Its diagnosis is often overestimated and needs precise bacteriological and cytological tests; systematic exploration of the urinary tract must be proposed if these tests are positive. The clinical presentation and the incidence of uropathies is strongly related to age.

A Weaver-like syndrome with endocrinological abnormalities in a boy and his mother.

A boy and his mother had dysmorphic features and accelerated growth of prenatal onset suggestive of the Weaver syndrome. Both had endocrinologic abnormalities. The boy had very low, hGH, which did not respond to stimulation.