Ventrally Fused Conjoined Twins (Omphaloischiopagus): A Roadmap to Successful Separation.

Conjoined twining is one of the most fascinating and challenging situations which a pediatric surgeon may face in his career. Only few surgeons may have the opportunity to share in separation of such cases. In this report, we aim to share our experience with the successful separation of ventrally fused male conjoined twins (omphaloischiopagus).

Histopathological perspective of the pulled-through colon in Hirschsprung disease: Impact on clinical outcome.

Background: The outcome in HD has not been always satisfactory even after a technically sound operation.

Purpose: To define the characteristic histopathological features of the pulled-through colon in patients with HD, and it is impact on clinical outcome.

Patients And Methods: The study included patients with HD who underwent surgical repair between 2010 through 2016.

Contrast enema as a guide for senna-based laxatives in managing overflow retentive stool incontinence in pediatrics.

Objectives: Overflow retentive stool incontinence (ORSI) is secondary to constipation and fecal loading. In our study, the dose and duration of senna-based laxatives (SBL) treatment to achieve full defecatory control will be examined for possible correlation with new parameters measured from the initial contrast enema.

Methods: Initially, an observational study was conducted prospectively on a group of patient with ORSI to define the optimum dose of SBL to achieve full defecatory control with measurement of six parameters in the initial contrast enema (level of colonic dilatation, recto-anal angle, ratio of maximal diameter of dilated colon to last lumbar spine, ratio of maximum diameter of dilated colon to normal descending colon, immediate and after 24-h post-evacuation residual contrast).

The double urethra: revisiting the surgical classification.

Aim: The aim of this article was to describe our experience with 14 patients with double urethra.

Patients And Methods: We retrospectively examined the patients' records including their clinical presentations, investigations, operative findings, and outcome. In addition to Effmann's classification, we used a newly proposed classification that depends on the orientation of the double urethral channels.

Feasibility and safety of monopolar diathermy as an alternative to clip ligation in laparoscopic Fowler-Stephens orchiopexy.

Purpose: The aims of the study were to study the effect of Fowler-Stephens orchiopexy (FSO) on testicular histology and to assess the feasibility of using monopolar diathermy as an alternative to clip ligation during laparoscopic FSO.

Patients And Methods: The study included 20 patients with 20 intraabdominal testes and short vessels managed by laparoscopic-staged FSO. Biopsies were taken from intraabdominal testes during the first and second stages of the procedure for histologic comparison.

Colonic conduit for esophageal replacement: long-term endoscopic and histopathologic changes in colonic mucosa.

Background: Long-term follow-up has substantiated the colon as a durable and highly acceptable esophageal substitute. Exposure of colonic conduit to gastric acid may lead to histopathologic changes in the form of chronic inflammation.

Materials/methods: Thirty children with esophageal replacement were studied from 2 to 12 years (mean, 5.

Pediatric minimally invasive surgery in Africa: limitations and current situation.

The second largest and most populous continent, with an exploding pediatric population, Africa has an overwhelming burden on its very limited pediatric surgical services. In an international environment of progressively advancing endoscopic and robotic surgical techniques, the authors focus on the current role of endoscopic surgery on the continent and explore the potential reasons for its delayed acceptance and implementation. They proceed to document the spectrum of what is available and, using their "African experience," expand on financially viable models of further rolling out these techniques, including discussion around suitable training models for surgeons and their teams.

Intra-abdominal testis: histological alterations and significance of biopsy.

Purpose: Intra-abdominal testes represent only 5% of undescended testes. Review of the literature reveals that few data exist on the histological analysis of intra-abdominal testes. We studied histological alterations in intra-abdominal testes in relation to patient age at orchiopexy.

Transperineal rectovesical fistula ligation in laparoscopic-assisted abdominoperineal pull-through for high anorectal malformations.

Background: Rectovesical fistula ligation after laparoscopic mobilization of the rectum requires either cutting of the fistula and application of endo-loop or laparoscopic endoligation or clip application. These techniques take more time and require a well-trained surgeon for performing the ligation laparoscopically. A simple technique for ligation of the fistula will be described.

Laparoscopic mucosectomy for large choledochal cyst.

Background: The laparoscopic excision of the choledochal cyst is feasible, but it entails certain difficulties while dealing with huge cysts because of the risk of injury of important surrounding structures. Mucosectomy of these large cysts is described in open surgery for huge adherent cysts, and the idea can be applied for laparoscopic excision.

Materials And Methods: Over a period of 5 years, 5 of 30 patients with a large choledochal cyst underwent the laparoscopic mucosectomy.

Collateral circulation after spermatic vessel ligation for abdominal testis and its impact on staged laparoscopically assisted orchiopexy.

Purpose: Staged laparoscopically assisted orchiopexy for abdominal testis entails initial spermatic vessels ligation followed by mobilization of the testis, preserving the vas and its vessels as a sole source of testicular blood supply. This mobilization includes all peritoneal attachments of the testis, including the gubernaculum, which may carry collateral circulation to the testis. This study considers the anatomy of the gubernaculum and the collateral circulation after spermatic vessels ligation and its possible effects on the viability of the testis.