Minimally Invasive Repair of Pediatric Morgagni Hernias Using Transfascial Sutures with Extracorporeal Knot Tying.

Background: Morgagni hernias are rare, with a reported incidence of 2% to 5% of congenital diaphragmatic hernias.

Objectives: To review a laparoscopic technique to repair Morgagni hernias in pediatric patients.

Methods: Retrospective chart review of pediatric patients who underwent minimally invasive repair of a Morgagni hernia from November 2009 to September 2017 within a defined population.

A new technique in complex chest wall reconstruction: Open reduction and internal fixation.

Background: Reconstruction of complex chest wall deformities is a surgical challenge. A new technique can improve long-term outcomes and result in high patient satisfaction.

Methods: A multicenter study was conducted on pediatric patients undergoing complex chest wall reconstruction between September 2015 and January 2018.

Laparoscopic redo nissen fundoplication after previous open antireflux surgery in infants and children.

Recurrent gastroesophageal reflux is a common complication after fundoplication procedures. We report our experience with laparoscopic redo Nissen fundoplications in pediatric patients with a history of open antireflux procedure. The medical records of all patients with a history of open antireflux procedure who underwent a subsequent laparoscopic redo Nissen fundoplication were reviewed.

Ingestion of magnetic toys: report of serious complications requiring surgical intervention and a proposed management algorithm.

Context: Increasing popularity of strong magnets as toys has led to their ingestion by children, putting them at risk of potentially harmful gastrointestinal tract injuries.

Objectives: To heighten physician awareness of the potential complications of magnetic foreign body ingestion, and to provide an updated algorithm for management of a patient who is suspected to have ingested magnets.

Design: A retrospective review of magnet ingestions treated over a two-year period at our institutions in the Southern California Permanente Medical Group.

An alternative to open incision and drainage for community-acquired soft tissue abscesses in children.

Background: The continually rising incidence of soft tissue abscesses in children has prompted us to seek an alternative to the traditional open incision and drainage (I&D) that would minimize the pain associated with packing during dressing changes and eliminate the need for home nursing care.

Study Design: A retrospective review of all patients with soft tissue abscesses from November 2007 to June 2008 was conducted after institutional review board approval. Patients who were treated with open I&D were compared to those treated with placement of subcutaneous drains through the abscess cavities.

Air insufflation of the stomach following laparoscopic pyloromyotomy may not detect perforation.

Background: Undetected perforation during laparoscopic pyloromyotomy can be fatal. Detecting a perforation at the time of laparoscopic pyloromyotomy is difficult. The purpose of this study was to determine whether air insufflation of the stomach reliably detects perforation during laparoscopic pyloromyotomy.

Laparoscopic contralateral groin exploration: is it cost effective?

Background: Transinguinal laparoscopy offers a safe and effective method for evaluating the contralateral groin during unilateral inguinal hernia repair (UIHR). The purpose of this study is to determine whether laparoscopic contralateral groin exploration (LCGE) is cost effective.

Methods: A retrospective review of all children who underwent UIHR and LCGE from 2006 to 2007 by a single surgeon was performed.

Initial experience with laparoscopic Chait Trapdoor cecostomy catheter placement for the management of fecal incontinence in children: outcomes and lessons learned.

Background: Antegrade enemas administered through a percutaneously placed Chait Trapdoor cecostomy catheter have resulted in a marked improvement in compliance and outcome of patients with fecal incontinence. The percutaneous technique, however, is a two-step procedure that is not performed under direct vision. This report presents the results and lessons learned from our experience with the laparoscopic approach to placement of Chait cecostomy catheters.

Metallic foreign body in the appendix of 3-year-old boy.

Foreign body-induced appendicitis is a rare but well-known entity. This condition was discovered during the first appendectomy performed almost 275 years ago. For the pediatric surgeon, evaluation of a patient for swallowed foreign bodies is common, and most foreign bodies traverse the gastrointestinal tract without incident.

Laparoscopic excision of a newborn rectal duplication cyst.

Congenital rectal duplication cyst is a rare entity treated with surgical excision. Without treatment, a rectal duplication cyst may cause a variety of complications, most notably, transforming into a malignancy. We report on a 7-week-old girl who was found to have a rectal duplication cyst.

Congenital bilateral absence of the vas deferens.

A 10-year-old boy with cystic fibrosis (CF) (DeltaF508/G551D mutation) underwent an uneventful elective interval laparoscopic appendectomy. During routine laparoscopic inspection of the abdomen and groins, congenital bilateral absence of the vas deferens was noted. Pictures of the patient's internal inguinal ring noted at time of laparoscopy are presented and compared with a similar-aged patient's internal ring with a normal vas deferens.

Current management of hernias and hydroceles.

The repair of inguinal hernia and hydrocele is one of the most common operations in a pediatric surgery practice. This work reviews current concepts in the management of the inguinal hernia and hydrocele. The authors describe current concepts of anesthetic management of children undergoing repair of inguinal hernia.

Lawnmower injuries in children: a 10-year experience.

Approximately 77,800 annual lawnmower-related injuries are treated in the USA, with 9,300 involving children. This work reviews the literature and reports our 10-year experience with lawnmower injuries. We retrospectively reviewed patients with lawnmower injuries admitted to the Women and Children's Hospital of Buffalo from 1995 to 2005 and reviewed the literature.

The learning curve associated with laparoscopic pyloromyotomy.

Background: Laparoscopic pyloromyotomy (LPM) for the treatment of infantile hypertrophic pyloric stenosis (HPS) has gained popularity in recent years. This study examines the learning curve associated with LPM.

Methods: We performed a retrospective analysis of patients undergoing LPM at a children's hospital between January 1, 1997 and June 30, 2003.

The anomalous splenic vein: a case report and review of the literature.

The spleen arises from a mesenchymal bulge at the 6-mm stage of development. There are a wide variety of splenic anomalies and variations that range from benign to clinically significant, and this article presents a brief review of splenic embryology and a case report of an anomalous splenic vein that precluded the formation of a Nissen fundoplication.

Pyloromyotomy: a comparison of laparoscopic, circumumbilical, and right upper quadrant operative techniques.

Background: Ramstedt pyloromyotomy through a right upper quadrant (RUQ) transverse incision has been the traditional treatment for hypertrophic pyloric stenosis. Recently, laparoscopic (LAP) and circumumbilical (UMB) approaches have been introduced as alternative methods to improve cosmesis, but concerns about greater operative times, costs, and complications remain. This study compares the three operative techniques and examines their advantages and complication rates.

Fraternal twins with Morgagni hernias.

Fraternal twins with identical left-sided foramen of Morgagni hernias are described. The occurrence of this rare type of congenital diaphragmatic hernia in twins suggests that genetic factors play a role in the formation of this lesion.

Mucinous cystadenoma of the pancreas in a one-year-old child.

Mucinous cystadenomas of the pancreas are uncommon lesions in adults and even more rare in children. This report presents a case of a pancreatic mucinous cystadenoma in a 1-year-old boy and offers a review of the literature and discussion of the surgical implications.