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Minimal-invasive Kinderchirurgie

Minimally invasive pediatric surgery

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Zusammenfassung

In den letzten Jahren wurden in der minimal-invasiven Kinderchirurgie große Fortschritte erzielt. In zahlreichen Studien wurde die sichere Durchführbarkeit für ein breites Spektrum laparoskopischer und thorakoskopischer Eingriffe im Kindesalter belegt. Zudem konnte gezeigt werden, dass minimal-invasive Operationen auch bei Kindern mit einer verminderten Morbidität, einer kürzeren Krankenhausverweildauer, besseren Kosmetik bei reduzierten Narben, geringeren Kosten und der konventionellen Chirurgie vergleichbaren Resultaten verbunden sind. Im vorliegenden Beitrag werden die bereits etablierten Verfahren den durchführbaren, aber noch nicht etablierten Prozeduren gegenübergestellt. Durch Abhandlung von potenziellen hämodynamischen, respiratorischen und organspezifischen Auswirkungen des verwendeten CO2-Pneumoperitoneums sowie der Vorstellung spezieller logistischer Vorraussetzungen, soll der Leser in der Indikationsstellung und Entscheidungsfindung minimal-invasiver Operationen im Kindesalter unterstützt werden.

Abstract

In recent years minimally invasive surgical techniques in children have made substantial progress. The feasibility and safety of a wide spectrum of laparoscopic and thoracoscopic procedures have been confirmed in numerous studies. Moreover, it was reported that minimally invasive pediatric surgery is associated with lower morbidity, a shorter hospital stay, lower costs, better cosmetics and clinical results similar to those achieved by open surgery. The present article reviews information on established as well as feasible but not yet established surgical procedures. The discussion of potential hemodynamic, respiratory and organ perfusion effects of the CO2 pneumoperitoneum and the notation of special logistic aspects should support the reader in the process of decision-making to schedule infants and children for minimally invasive surgery.

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  1. Klinik für Kinderchirurgie, Medizinische Hochschule, Carl-Neuberg-Straße 1, 30625, Hannover, Deutschland

    M.L. Metzelder & B.M. Ure

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  1. M.L. Metzelder
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  2. B.M. Ure
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Correspondence to M.L. Metzelder.

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Metzelder, M., Ure, B. Minimal-invasive Kinderchirurgie. Chirurg 81, 71–82 (2010). https://doi.org/10.1007/s00104-009-1847-0

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  • DOI: https://doi.org/10.1007/s00104-009-1847-0

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