Hepaticoduodenostomy as a technique for biliary anastomosis in children with choledochal cyst: An experience with 31 cases

Objective The aim of this study was to investigate the efficacy and complications of hepaticoduodenostomy in the treatment of choledochal cyst in children. Summary background data The conventional treatment of choledochal cyst includes Roux-en-Y hepaticojejunostomy for biliary reconstruction. This procedure, however, disrupts normal bowel continuity and requires two anastomoses. We studied the technique of hepaticoduodenostomy as an effective alternative to this technique.Patients and methods A total of 31 children undergoing  hepatoduodenostomy for choledochal cyst over a period of 9 years were included in this study.Results The patients operated upon had outcomes similar to those treated by the Roux-en-Y technique in other studies.Conclusion Hepaticoduodenostomy is an effective alternative to the conventional Roux-en-Y anastomotic technique in cases of choledochal cyst in children. Keywords: choledochal cyst, hepaticoduodenostomy, pediatri

Role of laparoscopic cholecystectomy in children

The present study is undertaken to establish the usefulness of laparoscopic cholecystectomy and to know its merits and demerits as compared to open cholecystectomy in children. In all, 28 patients who underwent cholecystectomy (8 open and 20 laparoscopic cholecystectomy) in B.Y.L. Nair hospital between July 1999 and March 2004 were analyzed. Calculous cholecystitis was found to be the most common indication for surgery. Operative time for laparoscopic cholecystectomy was more than that in open cholecystectomy in the early phase of laparoscopy, which got reduced as we gained experience. The requirement of parenteral antibiotics and analgesics and the duration of stay were significantly shorter with laparoscopy. The advantages for a child in laparoscopic cholecystectomy as compared to open cholecystectomy are minimal pain, avoidance of an upper abdominal incision, cosmesis and shorter duration of hospitalization with quick return to home and school. Thus, laparoscopic cholecystectomy is safe and efficacious in children

Neonatal lingual gastric duplication cyst: A rare case report

Enteric duplication cysts occurring in tongue is rare. They present with feeding difficulty and rarely with respiratory distress. A one day old male baby presented with swelling in the oral cavity, interfering with feeding and inability to close the mouth. Under general anesthesia, subtotal excision was done and histopathology was gastric duplication cyst of fundic variety

Laparoscopic management of neonatal ovarian cysts

The first prenatal detection of an ovarian cyst was by Valenti in 1975. Since then antenatal and neonatal ovarian cysts are encountered more frequently due to the improvement of imaging techniques as well as routine antenatal ultrasound scanning. We discuss here the laparoscopic management of three cases of neonatal ovarian cysts. This approach is well tolerated by neonates, and it may overcome the controversy between the ′wait and see′ policy and early surgical intervention, as laparoscopy has both diagnostic and therapeutic value with minimal morbidity, and ovarian salvage whenever possible

Laparoscopic surgery of inguinal hernia in children - experience with 110 repairs

Background: Laparoscopic inguinal herniorraphy has been in practice in adults since its initial description by Ger in 1921. However there is no standardized technique for children until now. We present a series 110 repairs of hernias in infants and children treated laparoscopically. The aim of this study is to document authors' experience with laparoscopy in inguinal hernia in girls and boys. Material and Methods: The procedure was performed with three ports, one telescopic and the other two for needle holders. The internal inguinal ring was closed with or without dissection of sac with stitches of 3-0® Vicryl. A total of 80 children underwent surgery. Results: Once the technique of intracorporeal suturing technique is mastered, the procedure is straightforward requiring 25 minutes for unilateral and 35 minutes for bilateral hernias. Age of the patient and size of the internal inguinal ring do not influence the outcome because of magnifying effect of laparoscopy. In more than half of our patients, the preoperative diagnosis could not be matched unequivocally with the intraoperative findings. There were three recurrences in the earlier phase of study before mastering the intracorporeal suturing technique. Apart from one case which developed transient hydrocele postoperatively, no other serious complications were noted. Conclusion: Laparoscopic repair of inguinal hernia in children has proved to be feasible, safe and reliable technique. A contralateral patent processus vaginalis (PPV) is present in a surprising number of young children and laparoscopy offers safe alternative to treat both sides at the same sitting. Cosmesis is superb

Transverse Micro-structuring of Photonic Crystal Fibers for Industrial Sensors and Side Viewing Probes for Optical Coherence Tomography Applications

In this work, we report a simple and easily adaptable technique of lateral micro-machining of Photonic Crystal fibers (PCFs) using modulated CO2-laser in conjunction with electrical arc system. The technique is controlled, convenient and precise over wide dimensions (50-250 mm). Lateral access to the holes of PCF provides additional flexibility for sensitive real time detection of gases such as green-house gases. Long period gratings are made in PCF through inscription of micro-grooves for sensitive detection of longitudinal strain. A unique and versatile PCF based probe for possible endoscopic Optical Coherence Tomography (OCT) applications is reported