Advances and Future Challenges of Minimally Invasive Surgery in Children

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Surgery".

Deadline for manuscript submissions: closed (15 March 2022) | Viewed by 32174

Special Issue Editor


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Guest Editor
Department of Pediatric Surgery, University Hospital of Split, Spinčićeva 1, 21000 Split, Croatia
Interests: laparoscopy; pediatric surgery; minimally invasive surgery; pediatric urology; testis; appendicitis; thoracoscopic surgery; testicular torsion; neonatal surgery; esophageal atresia; varicocele; acute scrotum; surgical infection
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Special Issue Information

Dear Colleagues,

The goal of minimally invasive surgery is to perform operations through very small incisions with equal or superior clinical outcomes and less impact on a patient’s body and organs. Minimally invasive surgery has become very popular over the last 30 years. Minimally invasive surgery in pediatric population was slow to advance but over the last 20 years has rapidly expanded to include all major pediatric surgical procedures in infants and children. The benefits to the patient are great, but the technical hurdles are many, because of the varied size and physiology of this patient population.

The goal of this Special Issue is to discuss all aspects of minimally invasive surgery in the pediatric population. Pediatric surgeons and researchers are invited to contribute their manuscripts from all aspects of minimally invasive surgery. Contributions can be of different character: original articles (prospective/retrospective studies), experimental studies, review articles, systemic reviews, new surgical techniques, and learning curves in minimally invasive surgery. Please avoid single case reports.

We look forward to receiving your contributions.

Prof. Dr. Zenon Pogorelić
Guest Editor

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Keywords

  • Minimally invasive pediatric surgery
  • Pediatric laparoscopic surgery
  • Video-assisted thoracic surgery (VATS) in children
  • Robotic pediatric surgery
  • Minimally invasive surgery in pediatric urology
  • Learning curves in minimally invasive pediatric surgery
  • Anesthesia in pediatric minimally invasive surgery

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Published Papers (4 papers)

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Editorial

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2 pages, 164 KiB  
Editorial
Advances and Future Challenges of Minimally Invasive Surgery in Children
by Zenon Pogorelić
Children 2022, 9(12), 1959; https://doi.org/10.3390/children9121959 - 13 Dec 2022
Cited by 3 | Viewed by 1180
Abstract
Minimally invasive surgery is a relatively new field of surgery where the surgeons operate through small incisions using a variety of techniques to perform less damage to the patient’s body than with conventional open surgery [...] Full article

Research

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12 pages, 1872 KiB  
Article
Comparison of the Standard vs. Thoracoscopic Extrapleural Modification of the Nuss Procedure—Two Centers’ Experiences
by Miloš Pajić, Damjan Vidovič, Radoica Jokić, Jelena Antić, Nenad Čubrić, Ivana Fratrić, Svetlana Bukarica, Aleksandar Komarčević and Marina Milenković
Children 2022, 9(4), 557; https://doi.org/10.3390/children9040557 - 14 Apr 2022
Cited by 2 | Viewed by 3361
Abstract
Pectus excavatum is the most common congenital anterior chest wall deformity, with an incidence of 1:400 to 1:1000. Surgical strategy has evolved with the revolutionary idea of Donald Nuss, who was a pioneer in the operative correction of this deformity using minimally invasive [...] Read more.
Pectus excavatum is the most common congenital anterior chest wall deformity, with an incidence of 1:400 to 1:1000. Surgical strategy has evolved with the revolutionary idea of Donald Nuss, who was a pioneer in the operative correction of this deformity using minimally invasive surgery. The aim of this paper is to compare the preliminary results of pectus excavatum repair in two University Centers with a moderate number of patients using the standard Nuss procedure and its modification, the extrapleural thoracoscopic approach. The statistical analysis showed no significant difference for the patient’s age (14.52 ± 3.70 vs. 14.57 ± 1.86; p = 0.95) and the CT Haller index (4.17 ± 1.58 vs. 3.78 ± 0.95; p = 0.32). A statistically significant difference was noted for the duration of a pectus bar implant (2.16 ± 0.24 vs. 2.48 ± 0.68; p = 0.03) between the Maribor and Novi Sad Center. We report 14 complications (28%), including dislocation of the pectus bar (10%), pleural effusion (8%), wound inflammation (6%), pericarditis (2%) and an allergic reaction to the pectus bar (2%). Standard and thoracoscopic extrapleural Nuss procedures are both safe and effective procedures used to correct a pectus excavatum deformity. The choice of surgical procedure should be made according to a surgeon’s reliability in performing a particular procedure. Our study found no advantages of one procedure over the other. Full article
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9 pages, 511 KiB  
Article
Independent Risk Factors for RBC Transfusion in Children Undergoing Surgery. Analysis of 14,248 Cases at a German University Hospital
by Florian Piekarski, Vanessa Neef, Patrick Meybohm, Udo Rolle, Wilfried Schneider, Kai Zacharowski and Elke Schmitt
Children 2021, 8(8), 634; https://doi.org/10.3390/children8080634 - 25 Jul 2021
Cited by 7 | Viewed by 2409
Abstract
Background: paediatric patients are vulnerable to blood loss and even a small loss of blood can be associated with severe shock. In emergency situations, a red blood cell (RBC) transfusion may become unavoidable, although it is associated with various risks. The aim of [...] Read more.
Background: paediatric patients are vulnerable to blood loss and even a small loss of blood can be associated with severe shock. In emergency situations, a red blood cell (RBC) transfusion may become unavoidable, although it is associated with various risks. The aim of this trial was to identify independent risk factors for perioperative RBC transfusion in children undergoing surgery. Methods: to identify independent risk factors for perioperative RBC transfusion in children undergoing surgery and to access RBC transfusion rates and in-hospital outcomes (e.g., length of stay, mortality, and typical postoperative complication rates), a monocentric, retrospective, and observational study was conducted. Descriptive, univariate, and multivariate analyses were performed. Results: between 1 January 2010 and 31 December 2019, data from n = 14,248 cases were identified at the centre. Analysis revealed an RBC transfusion rate of 10.1% (n = 1439) in the entire cohort. The independent predictors of RBC transfusion were the presence of preoperative anaemia (p < 0.001; OR = 15.10 with preoperative anaemia and OR = 2.40 without preoperative anaemia), younger age (p < 0.001; ORs between 0.14 and 0.28 for children older than 0 years), female gender (p = 0.036; OR = 1.19 compared to male gender), certain types of surgery (e.g., neuro surgery (p < 0.001; OR = 10.14), vascular surgery (p < 0.001; OR = 9.93), cardiac surgery (p < 0.001; OR = 4.79), gynaecology (p = 0.014; OR = 3.64), visceral surgery (p < 0.001; OR = 2.48), and the presence of postoperative complications (e.g., sepsis (p < 0.001; OR = 10.16), respiratory dysfunction (p < 0.001; OR = 7.56), cardiovascular dysfunction (p < 0.001; OR = 4.68), neurological dysfunction (p = 0.029; OR = 1.77), and renal dysfunction (p < 0.001; OR = 16.17)). Conclusion: preoperative anaemia, younger age, female gender, certain types of surgery, and postoperative complications are independent predictors for RBC transfusion in children undergoing surgery. Future prospective studies are urgently required to identify, in detail, the potential risk factors and impact of RBC transfusion in children. Full article
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Other

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6 pages, 1484 KiB  
Case Report
Congenital Hypertrophic Pyloric Stenosis in a Preterm Dizygotic Female Twin Infant: Case Report
by Besiana P. Beqo, Alireza Basharkhah and Emir Q. Haxhija
Children 2022, 9(4), 573; https://doi.org/10.3390/children9040573 - 17 Apr 2022
Cited by 2 | Viewed by 3699
Abstract
Infants with hypertrophic pyloric stenosis are usually diagnosed at about 3 to 8 weeks of age. The clinical onset of symptoms in preterm babies is observed normally at a later age than in term or post-term newborns. This report describes a rare case [...] Read more.
Infants with hypertrophic pyloric stenosis are usually diagnosed at about 3 to 8 weeks of age. The clinical onset of symptoms in preterm babies is observed normally at a later age than in term or post-term newborns. This report describes a rare case of a 2-day old preterm twin girl presenting with drinking laziness and recurrent vomiting. Five days after the beginning of symptoms and after several studies, including an upper gastrointestinal contrast study, the diagnosis of hypertrophic pyloric stenosis was made and confirmed at surgery. The postoperative course was uneventful. Interestingly, the mother of the child herself had a history of postnatal surgery on her fifth day of life due to congenital hypertrophic pyloric stenosis. To our best knowledge, this is the first report in the literature describing congenital hypertrophic pyloric stenosis in a mother and her child. Full article
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