Request PDF on ResearchGate | Síndrome de hipoglucemia por hiperinsulinismo endógeno: tratamiento quirúrgico | Background The. O hiperinsulinismo (HI) é a causa mais comum de hipoglicemia, seja transitória ou permanente. A HI é caracterizada pela secreção inadequada de insulina. ;92(8)– Sı´ndrome de hipoglucemia por hiperinsulinismo endo´ geno: tratamiento quiru´rgico resumen Palabras clave: Introduccio´n: El sı´ ndrome.
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The patient was placed in a prone position at the edge of the operating table. A 5mm, degree angled scope was introduced one fingerbreadth below the lower angle of the scapula. Two 3mm working ports were also inserted; the first in the same hiperinsulinizmo space as the camera port 3cm from the middle line and the second as high as possible in the axilla.
A thin fibrous strand was found connecting hiperinslinismo ends of the esophagus. The azygos vein was left intact. Blunt dissection was used throughout the whole procedure to preserve the aortic branches to the lower pouch, dissecting in between them.
Without traction, the distance between both pouches was approximately 4cm or 4 vertebral bodies. No tracheoesophageal fistula TEF was identified. The operative time was 85 minutes. The postoperative period was uneventful. Nasogatric tube feeding started on postoperative day 2, and the patient was discharged on postoperative day 6 after performing a contrast swallow test ensuring that there is no leakage.
Inanimate model to train for the thoracoscopic repair of all varieties of left congenital diaphragmatic hernia CDH. We present a new low-cost model designed for training skills and strategies for the thoracoscopic repair of left congenital diaphragmatic defects. We will present guidelines to make this type of models, the educational strategy that we use in our advanced training models, the defects that can be trained, and the scope of this model. Advanced training, learning tips and tricks from experts, and the use of innovative ideas from other authors used in our model are outlined.
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This educational tool was developed for pediatric surgeons requiring advanced training. It reinforces the concept of advanced and continuous training, in a safe environment, and it is assisted by experienced surgeons.
This model shows a scenario where dimensions and anatomical repairs are carefully preserved. We share our vision of continuous endosurgical education to encourage all enthusiastic surgeons to train in safe and controlled environments. The model consists in a plastic 3D printed left rib cage, extracted from a 6-month-old baby CT-scan combined with simulated mediastinal structures, diaphragm, bowel, lung, and spleen made of latex, silicone, and polyester sponge respectively.
A self-adhesive film is used as parietal pleura. A removable part spare part represents the last three ribs where the diaphragm is partially inserted, and a base as the upper abdomen is assembled to the left rib cage ribs 1 to 9. Abdominal viscera plastic or animal are placed in this base. The model is meant to simulate the most frequent diaphragmatic defects such as type A, B, and C, with or without sac. However, other rare defects can also be simulated. Live animal tissues such as diaphragm or intestine also can be used, as it was already published by other authors.
However, the main characteristic of this model is to be inanimate, portable, and easily reloadable to be reused.
The video shows a junior surgeon in his advanced training process. In the model, we perform the reduction of the viscera slid to the thorax. In this case, it is the rabbit intestine, but we usually use latex simulated intestine.
Insulinorresistencia e hiperinsulinemia como factores de riesgo para enfermedad cardiovascular
The spleen is completely synthetic and bleeds if the instruments damage it during the reduction. We use 3mm regular instruments.
We collect the performance data in a specially prepared form and carry hiperinsuliniemo the debriefing. With this model, we hiperinsuliniemo reinforce the concept of low cost, but with a high precision environment simulation, included within a standardized training program in minimally invasive neonatal surgery. We believe that it is a very useful tool. In addition, this type of models allows the use of new surgical techniques, tips and tricks given by experienced surgeons who assist in the training process.
Pediatric laparoscopic approach of a hydatid cyst of the lung. Hiperimsulinismo management of a catecholamine-secreting paraganglioma in a year-old boy.
We report the case of the surgical removal of a paravesical paraganglioma located on the right vesicoureteric junction in a year-old boy who was screened positive for SDHB gene mutation, which his father suffers from. Indeed, his dad died of a metastatic paraganglioma, notably including bone and cerebral metastases. The patient has tratamiejto complaining of major headaches for some time, which were triggered off during urination to the point that he hiperinsulunismo in urine as long as possible during daytime in order to avoid urinating, and this seemed to be immediately related to the onset of severe headaches.
The tumor location hiperinsulnismo to correctly understand the phenomenon intraoperatively since every bladder mobilization would induce abrupt bouts of high blood pressure. Resting blood pressure did not evidence any particular anomaly. However, there were high fluctuations in blood pressure, notably when headaches were reported. The tumor was located exactly at the vesicoureteric junction. It necessitated the resection of the lower ureter and the placement of a vesical patch.
Complete hratamiento resection allowed to eliminate all symptoms. The resection was performed without paying attention to the potential difficulties related to the type hiperinsuinismo reconstructive surgery which entailed. Reconstruction of the vesicoureteric junction was achieved without any major problem on a slightly reduced bladder. A minimal hiperinsulunismo reimplantation was performed according to the Lich-Gregoir technique, with bladder closure onto a vesical drain and a vesicoureteric double J catheter.
Immediate outcomes were uneventful and control performed more than one year postoperatively testified to the absence of tumor recurrence and to the very good functioning of the vesicoureteric junction.
Traditionally, surgical removal of the spleen was performed by an open approach using either an upper midline or left subcostal incision. With the advent of minimally invasive techniques, laparoscopic splenectomy has become a standard procedure for elective removal of the spleen for most indications.
In this lecture, Dr. Steven Rothenberg presents his procedure for standard laparoscopic and single port splenectomy. Laparoscopic treatment of a duodenal atresia in a newborn. The video “Laparoscopic treatment of a duodenal atresia in a newborn”, authored by F Becmeur, is analyzed by Dr. Munther Haddad, MD, trqtamiento in this way his own personal experience and highlighting the different surgical approaches available with tips and tricks.
Laparoscopic treatment of hydatid cyst of the liver in pediatric patient.
Laparoscopic reduction of intussusception in a month-old child. This video shows how an ileocolic intussusception in a young child can be managed laparoscopically. S RothenbergT Ponsky.