The position of the common facial vein in neonates: An alternate route for central venous catheter placement.

INTRODUCTION: We determine the location of the common facial vein (CFV) in a sample of neonates and assess the safety of this vein as an alternative access route for a central venous catheter (CVC). MATERIALS AND METHODS: We dissected both the left and right sides of the neck region in 24 neonatal, formalin-fixed cadavers, exposing the underlying soft tissues and neurovascular structures. We identified the CFV, which we then pinned together with the internal jugular vein, cervical branch of facial nerve, marginal mandibular branch of the facial nerve, the cricoid cartilage, brachiocephalic vein, and the mastoid and sternal attachments of the sternocleidomastoid muscle. We measured the CFV and the related pinned structures. RESULTS: In neonates, the CFV intersected the anterior border of sternocleidomastoid on average 19.53 mm (left) and 21.73 mm (right) from its sternal attachment. CONCLUSION: We found the CFV inferior to the upper one third and just superior to half of the length of the sternocleidomastoid muscle, indicating a possible "safe-zone" where a skin incision could be made over the anteromedial border of sternocleidomastoid. The CFV is easily identified from surrounding landmarks. It could be used as a safe, alternative route for inserting a CVC if its average length (8.72 mm) and diameter (1.50 mm) are taken into account.

Laparoscopic Morgagni hernia repair using single-site umbilical and full-thickness abdominal wall repair: technical report of two cases.

Single incision laparoscopic surgery is used in many centres for routine cases such as appendectomy, splenectomy and cholecystectomy. Morgagni hernias are uncommon and account for 1-2% of all congenital diaphragmatic hernia. We report our first laparoscopic repair of two Morgagni hernias, using a single umbilical incision and full-thickness abdominal wall repair with standard straight laparoscopic instruments. Operative time was short and compared favourably with the laparoscopic repair.

Laparoscopic-assisted pull-through for congenital rectal stenosis.

Congenital rectal stenosis is a rare condition. In this article, we report on a 30-day-old infant with rectal stenosis who underwent a successful laparoscopic pull-through operation. The laparoscopic method allows the surgeon to mobilize the rectum within the muscle complex without the division of any muscles of continence.

Thoracoscopic repair for a pleuroperitoneal communication in a child on peritoneal dialysis.

Massive hydrothorax is an uncommon complication in children on continuous ambulatory peritoneal dialysis (CAPD). In this paper, we present a case of a 6-year-old child on CAPD presenting with an acute hydrothorax after the introduction of peritoneal dialysis. The diagnosis was confirmed with thoracocentesis and comparing the presence of high glucose concentration in the aspirate to that of the serum. Video-assisted thoracoscopic surgery was performed, and a pleuroperitoneal communication was found and repaired. CAPD was resumed 1 week later. We recommend thoracoscopic repair as the first-choice method for repair of pleuroperitoneal communications in pediatric patients.