Laparoscopic transperitoneal repair of pediatric diaphragm eventration using an endostapler device.
J Laparoendosc Adv Surg Tech A
; 23(9): 808-13, 2013 Sep.
Article
en En
| MEDLINE
| ID: mdl-23937143
ABSTRACT
BACKGROUND:
Minimally invasive repairs of pediatric diaphragm eventration have been well described via a thoracoscopic approach, oftentimes requiring single-lung ventilation and tube thoracostomy, with the disadvantage of not being able to clearly visualize what lies beneath the diaphragm. We describe a novel pediatric diaphragm eventration repair using a laparoscopic transperitoneal approach and an endostapler device. We also describe our initial experience with this technique. PATIENTS ANDMETHODS:
Four pediatric diaphragmatic eventration patients underwent laparoscopic transperitoneal repair using an endostapler device. Repairs were performed in both male and female patients with right-sided eventrations. We approach the repair in a transperitoneal fashion using inverting sutures at the apex of the diaphragm to create tension toward the pelvis. Subsequently, an endostapler is used to remove the redundant portion of diaphragm, leaving a repaired, taut diaphragm.RESULTS:
The median age at operation was 10.5 months. The median operative time was 70 minutes. There was no mortality, surgical complications, or recurrence at a median follow-up of 17 months.CONCLUSIONS:
This laparoscopic approach allows for clear visualization of the intraabdominal organs and, at least in our early experience, a very simple, straightforward operation. Additionally, with the use of the endostapler, the redundant, often weakened diaphragm is removed, leaving the native, healthy diaphragm behind, resulting in a reliable and reproducible repair. This repair should be considered as a feasible alternative approach to the more traditional open and thoracoscopic repairs.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Peritoneo
/
Laparoscopía
/
Grapado Quirúrgico
/
Eventración Diafragmática
Límite:
Child
/
Female
/
Humans
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Infant
/
Male
Idioma:
En
Revista:
J Laparoendosc Adv Surg Tech A
Año:
2013
Tipo del documento:
Article
País de afiliación:
Estados Unidos