Full Description
Esophageal atresia is a common neonatal emergency, and surgical repair in the newborn period is conventionally achieved by thoracotomy. With the development in pediatric minimal access surgery, esophageal atresia repair has been done with thoracoscopy after its first description in 1999. Many centers now prefer the thoracoscopic approach, which is claimed to be beneficial in terms of outcome both in the short and long term. Neonatal thoracoscopy is a difficult procedure and has a long learning curve. It requires a team approach with a competent anesthetist and surgical assistant. A surgeon alone cannot accomplish this procedure. This book presents comprehensive details on the procedure of thoracoscopic repair of esophageal atresia. The chapters sequentially explain all the procedure steps, from setup, instrumentation, patient selection, and ergonomics to detailed stepwise descriptions of the operative procedure. Since esophageal atresia can have so many variations in anatomy, the chapters cover how to tackle these variations. To keep the reader's interest, a detailed review of history and current literature, along with controversies, is presented. Interested readers will start from the history as the first chapter and can go through the descriptions of the entire procedure from start to finish. Any Pediatric surgery trainee interested in Pediatric Minimal access discipline will find this book as a one-stop resource on everything he wants to know about Thoracoscopic repair of esophageal atresia. The book also includes coverage of non-surgical aspects such as anesthesia and ventilation and effects on cerebral oxygenation during thoracoscopy. The book provides easy-to-understand English and is richly supplemented with illustrations and high-resolution operative photographs. Video clips also supplement the text wherever an operative step is explained. These videos are linked to the publisher's website for easy access.
Contents
Thoracoscopic Repair of Esophageal Atresia and Tracheo-esophageal fistula (TREAT): A brief introduction to the current state of the art and surgical history.- The anatomy of neonatal chest and mediastinum in relation to thoracoscopy and esophageal atresia.- Case selection, basic instrumentation, and operation theatre layout for TREAT.- Anesthesia and ventilation for thoracoscopic esophageal atresia repair.- Positioning patient and Port placement in chest for thoracoscopic esophageal atresia repair.- Thoracoscopic repair of Type-C esophageal atresia with classic anatomy.- Right aortic arch and esophageal atresia: Understanding the anatomy and thoracoscopic approach.-Conversion to open, intra-operative complications and management during TREAT (vascular injury/ tracheal injury).-Short term complications and management after TREAT.- Long gap esophageal atresia and thoracoscopic approach.- Thoracoscopic versus open repair for esophageal atresia: The current evidence.-Simulation and Ex-vivo training of surgeons for thoracoscopic repair of esophageal atresia.- Controversies and contentious issues in thoracoscopic approach for repair of esophageal atresia.- Cerebral oxygenation during thoracoscopic repair of esophageal atresia.- Pictorial Essay of Thoracoscopic repair of esophageal atresia.- Operation theatre challenges, integration, and team coordination during neonatal minimal access procedure.- Long term Musculo-skeletal implications of neonatal thoracotomy: Is thoracoscopy worth the hype?.
