Laproscopic pericardial fenesrtration-_video_presentation_no_video
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A 10-year-old girl with a history of congenital heart defects and prior cardiac surgeries was hospitalized for 45 days due to a pericardial effusion that could not be drained through repeated pericardiocentesis attempts. The effusion was affecting the outcomes of her cardiac procedures. A laparoscopic pericardial fenestration was performed to drain the pericardial collection through an abdominal route since the chest bore multiple scars from prior surgeries. The procedure was performed minimally invasively using four abdominal ports under transoesophageal echocardiographic guidance. The patient recovered well with resolution of the effusion and was discharged on the fourth postoperative day. Follow up at
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This document discusses pediatric day surgery (PDS) and day case laparoscopic surgery (DCLS) at Apollo Children's Hospital in Chennai, India. It provides details on: the history and increasing use of PDS; patient selection criteria for DCLS; anesthesia and surgical protocols used; a retrospective analysis of 85 DCLS cases with no reported complications; and conclusions that DCLS can be performed safely without compromising patient care when a multidisciplinary team approach and clinical care pathway are followed.
Thoracoscopy vs laparoscopy technical feasibility and complications in cong...
Thoracoscopy and laparoscopy are minimally invasive surgical techniques that can be used to repair congenital diaphragmatic hernias. Thoracoscopy is typically used to repair Bochdalek hernias while laparoscopy is used for Morgagni and paraesophageal hernias. Both techniques have advantages over open surgery such as reduced pain, faster recovery, and less postoperative ventilation. However, thoracoscopy carries risks of abdominal organ injury during suturing while laparoscopy makes reduction of herniated organs more difficult. The author's experience found thoracoscopy had a higher success rate and fewer complications compared to laparoscopy for CDH repair in selected neonatal patients. Selection criteria and
Thoracoscopic neurofibroma
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Hirschsprungs disease
This document discusses the case of a newborn male patient presenting with symptoms of Hirschsprung's disease including abdominal distention and failure to pass meconium. Diagnostic testing revealed the absence of ganglion cells in the colon consistent with Hirschsprung's disease. The patient underwent an end colostomy and biopsy which confirmed the diagnosis. He recovered well and was discharged with plans for a future pull through surgery.
Achalasia cardia 2003
This document describes a case of a 6 month old male infant who presented with feeding difficulties, vomiting after feeding, respiratory infections, and weight loss. Examination found the infant to be underweight. Investigations including chest X-ray, barium swallow, and blood tests were performed. The infant was diagnosed with achalasia cardia based on findings on barium swallow. The infant underwent a laparoscopic cardiomyotomy with Dor's fundoplication procedure. The procedure and post-operative recovery were uneventful, and the infant was able to tolerate feeds well after being discharged on day 5. References are provided on laparoscopic treatment of achalasia cardia.
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Laproscopic pericardial fenesrtration-_video_presentation_no_video
- 1. Laparoscopic pericardial fenestration A video presentation Rajiv Padankatti Prakash Agarwal R K Bagdi Neville Solomon
- 2. Case history 10 yr old girl child Known case of DORV/ VSD/ PS Underwent Glen shunt -1st surgery 5 months back Redo- Rastelli procedure 2 months back Post op pleural effusion needing prolonged ICD repeated pleurodeisis Hopitalised for almost 45 days
- 3. Problem Pericardial effusion not manageable by pericardiocentesis – done twice Inability to approach through the thorax Her chest already bore multiple scars A more permanent solution for the effusion/ chylous fluid in the pericardium was sought The effusion was affecting outcome of cardiac procedure
- 4. Pediatric surgeons’ role Abdominal route was the only way to drain the pericardial collection Child and parents were upset about the scars on the chest/ ICD sites Was there a solution - minimally invasive? We searched the Internet
- 5. Literature Iranian Journal of Medical Sciences. Vol. 20, 1995 Laparoscopic Pericardial Fenestration in Malignant Pericardia Effusion Surgical Endoscopy Vol 16, 2002 Laparoscopic transabdominal pericardial window – New standard in the treatment of recurrent pericardial effusion complicated by cardiac tamponade Bratisl Lek Listy Vol 108, 2007 Miniinvasive treatment of pericardial effusions
- 6. Technical details Supine position 4 ports as shown Continuous transoesophageal echocardiographic monitoring Pressures of 10-12, flow of 4 Pressures reduced after pericardial window
- 8. Post-op period Child shifted to ICU for monitoring No ascites documented by scan after 48 hours Good resolution of pericardial effusion Pleural effusion – ICD removed after 48 hours HPE of pericardium – Chronic Inflammation Discharged on 4th postop day
- 9. Follow up No ascites No pericardial effusion Good improvement in cardiac function No diaphragmatic hernia At 1 week and 1 month F/U