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Paediatric Surgery
Principles of Minimally Invasive Surgery
Built from Puri — Pediatric Surgery and Pediatric Urology
What’s inside
8 sections · 57 slides
Overview
- What this deck covers
What Minimally Invasive Surgery Is
And why it matters in children
- From keyhole to complex reconstruction
- Why children are a special case
- Laparoscopy versus robotics
- The shared benefits that drive adoption
Anaesthetic Considerations
Operating inside a gas-filled abdomen
- Why anaesthesia has to adapt
- Preoperative work-up and induction
- Pneumoperitoneum: gas changes the physiology
- Why carbon dioxide is the insufflation gas
- Insufflation pressure must match the child
Laparoscopic and Robotic Procedures
Positioning, access and the operating room
- How the procedure list grew
- Positioning for pelvic (Trendelenburg) cases
- Port positioning for robotic pelvic surgery
- Positioning for renal (lateral) cases
- Port positioning for left-sided robotic renal surgery
- Retroperitoneal versus transperitoneal access
- Getting into the abdomen safely
- Blunt-tip trocar with retention balloon
- Where the ports go
- Operating room layout for a left renal robotic case
Complications
Recognising, preventing and managing them
- How MIS complications are organised
- Complications by timeline
- Positioning nerve injuries
- Access complications from the Veress needle
- Systemic effects of pneumoperitoneum
- Gas embolism: rare but potentially fatal
- Gastrointestinal and traction injuries
- Bleeding and port-related vascular injury
- Port-site hernias and equipment failure
Current Controversies
Cost, time, benefit and training
- The debate in a nutshell
- Cost and operative time
- Why the benefits matter most in children
- Training and the human-capital cost
Future Directions
Where the technology is heading
- Better instrumentation
- 5 mm robotic instrumentation
- The miniaturization hurdle
- Comparison of 5 mm and 8 mm robotic instruments
- Single-port surgery
- Telesurgery and tactile feedback
- Augmented visualization
- Future directions at a glance
Summary
The key take-home points
- Three things to remember
- Take-home messages
- References (1/5)
- References (2/5)
- References (3/5)
- References (4/5)
- References (5/5)
- Pediatric Surgery and Pediatric Urology