Evaluation of the Appropriate LigaSure™ Device to Transect the Appendix-A Comparison between 5 mm and 10 mm Laparoscopic Devices in an Ex Vivo Trial.

: A topic of greatinterest in the surgical field comprises cost and time reduction operative techniques with high efficiency rates. Thus, the aim of this paper is to evaluate whether a transection of the appendix using only a laparoscopic LigaSure™ device is feasible and, if so, which size of the laparoscopic device is optimal. : Appendectomy specimens were sealed and cut using LigaSure V (5 mm) and LigaSure Atlas (10 mm) devices ex vivo.

Evaluating Cardiac Lateralization by MRI to Simplify Estimation of Cardiopulmonary Impairment in Pectus Excavatum.

Background: The severity of pectus excavatum is classified by the Haller Index (HI) and/or Correction Index (CI). These indices measure only the depth of the defect and, therefore, impede a precise estimation of the actual cardiopulmonary impairment. We aimed to evaluate the MRI-derived cardiac lateralization to improve the estimation of cardiopulmonary impairment in Pectus excavatum in connection with the Haller and Correction Indices.

Surgeons' requirements for a surgical support system to improve laparoscopic access.

Creating surgical access is a critical step in laparoscopic surgery. Surgeons have to insert a sharp instrument such as the Veress needle or a trocar into the patient's abdomen until the peritoneal cavity is reached. They solely rely on their experience and distorted tactile feedback in that process, leading to a complication rate as high as 14% of all cases.

Differences in myocardial strain between pectus excavatum patients and healthy subjects assessed by cardiac MRI: a pilot study.

Objectives: To evaluate differences in myocardial strain between pectus excavatum (PE) patients and healthy subjects (HS) assessed by cardiac MRI using the feature-tracking algorithm.

Methods: Cardiac MRI was performed in 14 PE patients and 14 HS (9:5 male to female in each group; age 11-30 years) using a 3T scanner. Post-examination analysis included manual biventricular contouring with volumetry and ejection fraction measurement by two independent radiologists.

Second study on the recurrence risk of isolated esophageal atresia with or without trachea-esophageal fistula among first-degree relatives: no evidence for increased risk of recurrence of EA/TEF or for malformations of the VATER/VACTERL association spectrum.

Background: Esophageal atresia with/without trachea-esophageal fistula (EA/TEF) denotes a spectrum of severe congenital malformations. The aim of this systematic study was to determine both the recurrence risk for EA/TEF, and the risk for malformations of the VATER/VACTERL association spectrum, in first-degree relatives of patients with isolated EA/TEF.

Methods: A total of 108 unrelated patients with isolated EA/TEF were included.

Decline in infantile hypertrophic pyloric stenosis in Germany in 2000-2008.

Background And Objective: The incidence of infantile hypertrophic pyloric stenosis (IHPS) is highly variable over time and geographic regions. A decline in IHPS incidence was recently reported in Sweden, the United States, Denmark, and Scotland. In Sweden, the IHPS decline seemed to be concurrent with a declining incidence in sudden infant death syndrome (SIDS), which suggested a common cause; the latter was attributed to campaigns against the prone sleeping position.

Pectus excavatum: history, hypotheses and treatment options.

Pectus excavatum and pectus carinatum represent the most frequent chest wall deformations. However, the pathogenesis is still poorly understood and research results remain inconsistent. To focus on the recent state of knowledge, we summarize and critically discuss the pathological concepts based on the history of these entities, beginning with the first description in the sixteenth century.

Pectus carinatum--first ultrastructural findings of a potential metabolic lesion.

The histological and ultrastructural findings of rib specimens after two re-interventions in the case of recurrence of pectus carinatum (PC) are presented in this report. A 15-year-old boy developed recurrences of mild PC after re-chondroplasties using the Ravitch technique. Histological study of the resected cartilage showed markedly degenerative changes of the sternocostal cartilage.

A microlaparoscopically assisted pull-through procedure for Hirschsprung's disease: initial experiences.

Purpose: The purpose of this prospective study was to evaluate the efficiency, feasibility, and surgical outcomes of microlaparoscopy-assisted pull-through (MAPT) for Hirschsprung's disease.

Methods: Starting in 2005, pull-through procedures for Hirschsprung's disease were performed exclusively using 2-mm instruments and miniscopes (microlaparoscopy). Three miniports were inserted laterally in the right abdominal wall in one line, with the miniscope at the level of the umbilicus and the working trocars cranially/caudally of the scope.

Microlaparoscopic cholecystectomy with an unorthodox scope position.

Purpose: We report our initial experiences with microlaparoscopic cholecystectomy (MLCE) in children using a 2.4-mm mini-scope placed to the right of the umbilicus. The umbilicus was used as the working trocar for large-diameter instruments.

Closure of the cystic duct during laparoscopic cholecystectomy in children using the LigaSure Vessel Sealing System.

Background: The goal of the present study was to evaluate the efficacy of the LigaSure(™) Vessel Sealing System (LVSS) when used for cystic duct closure during laparoscopic cholecystectomy in children and adolescents.

Methods: The laparoscopic cholecystectomy was performed beginning with visualization of Calot's triangle, and dissection of Calot's triangle was achieved using a monopolar cautery device. Once the cystic duct was exposed, sealing was performed proximally and distally, and the cystic duct was divided midway using the LVSS.

The use of a plastic bag from a drain package instead of an endobag in children: a safe, effective, and economical alternative.

Purpose: The standard endobags require large trocars; because the authors routinely use 2- to 5-mm instruments, they were looking for complementary specimen retrieval device alternatives. For this purpose, they recently used a plastic bag from a drain package to exteriorize abdominal masses during laparoscopy in children.

Method: A plastic bag from a drain package--the innermost cover--was placed into the abdominal cavity trough a 5-mm trocar.

Microlaparoscopic pyloromyotomy in children: initial experiences with a new technique.

Introduction: We conducted a prospective feasibility study to evaluate the value of microlaparoscopic pyloromyotomy for hypertrophic pyloric stenosis in infants.

Methods: All data were prospectively collected, and the procedures were documented by video recording. Patients were selected based on the availability of the equipment and consultant surgeons experienced in microlaparoscopy.

Laparoscopic inguinal herniorrhaphy in babies weighing 5 kg or less.

Background: This retrospective study aimed to evaluate the feasibility, safety, and complication rate of laparoscopic inguinal hernia repair for small babies weighing 5 kg or less compared with the traditional open herniotomy.

Methods: A retrospective analysis was performed on the surgical charts of 147 infants weighing 5 kg or less who underwent laparoscopic hernia repair. Either a regular 5-mm scope or a microlaparoscope was used for visualization, and 2-mm instruments were used for closure of the inner inguinal ring.

Feasibility of microlaparoscopy for surgical procedures of advanced complexity in children.

Unlabelled: Abstract Purpose: We conducted a prospective study to determine the value and the feasibility of the microlaparoscopic approach for surgical procedures of advanced complexity in children. We report our experience with these small instruments. We also report the preliminary results of a recently developed 2.

Microlaparoscopic-assisted gastrostomy in children: early experiences with our technique.

Introduction: The aim of this prospective study was to evaluate the feasibility and safety of a new technique for microlaparoscopic-assisted gastrostomy (MAG) in children and infants by using a 1.9-mm scope only. In this paper, we report our early experiences with this method.

Laparoscopic inguinal hernia repair does not impair testicular perfusion.

Background: Laparoscopic inguinal hernia repair techniques close the internal ring with a suture. Concern has been raised whether or not the testicular vessels are compromised with this technique. This study was undertaken to evaluate pre- and postoperative testicular perfusion and to compare it with healthy controls.

Laparoscopic treatment of urachal remnants in children.

Purpose: Urachal remnants are generally treated with the open method. We evaluated the role of laparoscopy for this anomaly in a consecutive series of 27 children treated during a 12-year period.

Materials And Methods: A total of 27 children with a median age of 4.