J Minim Invasive Surg 1999; 2(1): 75-84
Published online May 29, 1999
© The Korean Society of Endo-Laparoscopic & Robotic Surgery
최인석, 김선한, 최원준, 김종석, 구범환
고려대학교 의과대학 일반외과학교실
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: The use of pediatric laparoscopy has been increasing. We summarize our experience of laparoscopy in a pediatic age group and describe the surgical techniques for these cases. Methods: From January 1998 to December 1998, eighteen cases of laparoscopy in infants and children (ranged, 6day newborn to 12-year child) were performed at the Department of Surgery, Korea University Ansan Hospital. All clinical data were collected prospectively. Results: The indications for laparoscopy were barium reduction failed intussusception (n=9), congenital hypertrophic pyloric stenosis (n=6), torsion of congenital ovarian cyst (n=1), traumatic splenic rupture (n=1), and corpus luteal rupture (n=1). In intussusception, laparoscopic management was successful in 6 patients (4 laparoscopic and 2 spontaneous reductions, success rate: 66.7%). Conversion to open procedure occurred in 3 patients due to poor operative vision with marked ileus (n=2) and friable colonic wall in ileo-ileo-colic type (n=1). Port-site seroma was developed in 1 case. In congenital pyloric stenosis, laparoscopic myotomy was successful in 4 cases. Duodenal mucosal perforation was developed in one case and managed by conversion to open procedure. In another case, small bowel obstruction with an incisional hernia at a 5-mm trocar site was developed postoperatively and managed surgically by extending the port site, reducing the herniated bowel, and closing the abdominal wall under the general anesthesia. Laparoscopic oophorectomy was safely taken in a 6-day newborn with congenital ovarian cyst torsion. The acute abdomen with corpus leteal rupture was managed by laparoscopic ligature and electric coagulation. Partial splenectomy was tried in a child with traumatic splenic rupture, however converted to laparotomy due to poor vision with bleeding. Conclusion: Laparoscopic can be safely performed in various disorders of infants, children, even in newborn baby. To prevent the complications related to trocar placement, 5-mm incision sites should be closed at the fascial level
Keywords Laparoscopy, Pediatric surgery
J Minim Invasive Surg 1999; 2(1): 75-84
Published online May 29, 1999
Copyright © The Korean Society of Endo-Laparoscopic & Robotic Surgery.
최인석, 김선한, 최원준, 김종석, 구범환
고려대학교 의과대학 일반외과학교실
In Seok Choi, M.D., Seon Hahn Kim, M.D., Won Jun Choi, M.D. Jong Seok Kim, M.D., Bum Hwan Koo, M.D.
Department of Surgery, Korea University College of Medicine, Seoul, Korea
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: The use of pediatric laparoscopy has been increasing. We summarize our experience of laparoscopy in a pediatic age group and describe the surgical techniques for these cases. Methods: From January 1998 to December 1998, eighteen cases of laparoscopy in infants and children (ranged, 6day newborn to 12-year child) were performed at the Department of Surgery, Korea University Ansan Hospital. All clinical data were collected prospectively. Results: The indications for laparoscopy were barium reduction failed intussusception (n=9), congenital hypertrophic pyloric stenosis (n=6), torsion of congenital ovarian cyst (n=1), traumatic splenic rupture (n=1), and corpus luteal rupture (n=1). In intussusception, laparoscopic management was successful in 6 patients (4 laparoscopic and 2 spontaneous reductions, success rate: 66.7%). Conversion to open procedure occurred in 3 patients due to poor operative vision with marked ileus (n=2) and friable colonic wall in ileo-ileo-colic type (n=1). Port-site seroma was developed in 1 case. In congenital pyloric stenosis, laparoscopic myotomy was successful in 4 cases. Duodenal mucosal perforation was developed in one case and managed by conversion to open procedure. In another case, small bowel obstruction with an incisional hernia at a 5-mm trocar site was developed postoperatively and managed surgically by extending the port site, reducing the herniated bowel, and closing the abdominal wall under the general anesthesia. Laparoscopic oophorectomy was safely taken in a 6-day newborn with congenital ovarian cyst torsion. The acute abdomen with corpus leteal rupture was managed by laparoscopic ligature and electric coagulation. Partial splenectomy was tried in a child with traumatic splenic rupture, however converted to laparotomy due to poor vision with bleeding. Conclusion: Laparoscopic can be safely performed in various disorders of infants, children, even in newborn baby. To prevent the complications related to trocar placement, 5-mm incision sites should be closed at the fascial level
Keywords: Laparoscopy, Pediatric surgery
Jae Hwan Jeong, Chang Moo Kang
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