Pediatric Endourology Techniques (eBook)

Mr. Prasad P. Godbole, Senior Fellow in Pediatric Urology, Department of pediatric urology, Great Ormond Street Hospital for Children, London, UK. Great Ormond Street is a world-renowned center for pediatric surgery and pediatric urology. For the last 25 years, it has been the only center in the United Kingdom and Europe to have a dedicated pediatric urology department as opposed to pediatric Surgeons doing some pediatric urology. The number of publications, research projects are testament to this. All the authors have established their niche, and further subspecialized, in the various aspects of pediatric urology, thus giving them a command over their area of expertise. Mr Patrick Duffy is the pioneer of pediatric minimally invasive stone management in the UK, getting referrals from most centers. Mr Imran Mushtaq has gained a reputation as an excellent pediatric laparoscopic urologist and will shortly start using the deVinci robot for laparoscopic urology. Mr Azad Najmaldin (from Leeds) is the pioneer of laparoscopy in children in the UK. All the authors, being dedicated pediatric urologists, have a high turnover of cases.

Foreword 5
Preface 7
Contents 9
Section A: Laparoscopy 9
Section B: Endoscopy 10
Section C: Miscellaneous 10
Contributors 11
Section A Laparoscopy 14
1 Laparoscopy in Children: Basic Principles 15
Anesthesia 15
Positioning 15
Access 15
Preparation 15
Approach 16
Visualization 21
Instrumentation 21
Tissue Retrieval 21
Wound closure 21
2 Nephrectomy and Heminephrectomy 25
Indications and Contraindications Approach 25
Preoperative Workup 26
Specific Instrumentation 26
Anesthesia 27
Operative Technique 27
Postoperative Management 29
Complications 29
3 Laparoscopic Pyeloplasty 31
Indications 31
Investigations 32
Instrumentation 32
Operative Technique 32
Postoperative Management 34
Complications 34
Conclusions 34
4 Transposition of Lower Pole Vessels: “The Vascular Hitch” 36
Instrumentation 36
Operative Technique Indications and Contraindications 36
Preoperative Investigations 36
Postoperative Care 40
Complications 40
Authors’ Experience 40
Conclusions 40
5 Laparoscopic Adrenalectomy 43
Indications 43
Anatomy 43
Contraindications 44
Preoperative Work Up 44
Specific Instrumentation 44
Anesthesia 45
Operative Technique 45
Postoperative Management 46
Complications 46
Author’s Experience 46
6 Transvesicoscopic Cohen Ureteric Reimplantation for Vesico-Ureteral Reflux in Children 51
Preoperative Investigations 51
Indications and Contraindications 51
Specific Instrumentation 52
Operative Technique 52
Postoperative Management 56
Results 56
Author Remarks 57
Conclusion 57
7 Impalpable Testis 61
Preoperative Preparation 61
Patient Position 61
Port Positioning 61
Operative Technique 61
Indications and Contraindications 61
Closure 65
Complications 65
Video Clips 65
8 Varicocelectomy (I) 66
Preoperative Patient Preparation 66
Specific Instrumentation 66
Schematic Diagram 66
Indications and Contraindications 66
Preoperative Investigation 66
Operative Technique 67
Postoperative Management 67
Complications 67
Author’s Remarks 67
9 Varicocelectomy (II) 68
Preoperative Investigations 68
Operative Technique 68
Indications and Contraindications 68
Postoperative Management 69
Complications 69
Author’s Remarks 69
10 Intersex and Laparoscopy 71
Indications 71
Preoperative Investigations 72
Operative Technique 72
Complications 74
Conclusion 74
Section B Endoscopy 77
11 General Principles of Cystourethroscopy 79
Indications and Contraindications 79
Preoperative Investigation 82
Preoperative Patient Preparation 82
Specific Instrumentation 82
Operative Technique 83
Postoperative Management 88
Complications 88
Author’s Remarks 88
12 STING for Vesicoureteral Reflux 89
Indications and Contraindications 89
Preoperative Investigation 90
Preoperative Patient Preparation 90
Specific Instrumentation 90
Operative Technique 92
Postoperative Management 94
Complications 94
Author’s Remarks 95
13 Bladder Outlet Injection for Urinary Incontinence 97
Indications and Contraindications 97
Preoperative Investigation 97
Preoperative Patient Preparation 98
Specific Instrumentation 98
Operative Technique 100
Postoperative Management 102
Complications 102
Author’s Remarks 103
14 Posterior Urethral Valves 104
Contraindications 104
Preoperative Investigation 105
Specific Instrumentation 105
Operative Technique 105
Complications 105
Conclusions 106
15 Endoscopic Management of Ureterocele and Syringocele 107
Preoperative Investigation and Preparation 107
Indications and Contraindications 107
Specific Instrumentation 108
Operative Technique 108
Postoperative Management 110
Complications 110
Author’s Remarks 110
16 Percutaneous Nephrolithotomy and Laparoscopic Management of Urinary Tract Calculi 113
Percutaneous Nephrolithotomy 114
Specific Instrumentation 114
Laparoscopy 116
Preoperative Investigations 117
17 Ureteroscopy in Children 118
Indications and Contraindications 118
Preoperative Investigation 118
Specific Instrumentation 119
Operative Technique 119
Postoperative Management 120
Complications 120
Conclusions 120
18 Minimally Invasive Management of Calculi in Augmented/Neuropathic Bladders 122
Preoperative Patient Preparation 122
Specific Instrumentation 122
Operative Technique Preoperative Investigation 122
Operative Management 123
Complications 123
Authors’ Remarks 123
Section C Miscellaneous 125
19 Laparoscopic Assisted ACE Procedure for Fecal Incontinence in Children (I) 127
Indications and Contraindications 127
Preoperative Investigation 127
Preoperative Patient Preparation 128
Operative Technique 128
Postoperative Management 129
Complications 129
Conclusion 130
References 130
20 Laparoscopic Assisted ACE Procedure for Fecal Incontinence in Children (II) 132
Patient Selection 132
Stoma/Caecostomy Tube or Caecostomy Button? 132
Indications and Contraindications 132
Preoperative Preparation 133
Specific Instrumentation 133
Operative Technique 133
Postoperative Management 134
Complications 134
Conclusions 134
21 Robotics and Pediatric Urology: Robotically Assisted Pyeloplasty in Children 137
Indications 137
Preoperative Investigation 137
Preoperative Patient Preparation 138
Specific instrumentation 138
Operative Techniques 139
Postoperative Management 140
Complications 140
Author’s Comment 141
Index 143