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Successful laparoscopic fundoplication in children with ventriculoperitoneal shunts
1Department of Pediatric Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871, Japan. kimutaku@pedsurg.med.osaka-u.ac.jp
Insights
Laparoscopic Nissen fundoplication is safe and feasible in pediatric patients with VATER association (VPS). This advanced laparoscopic surgery can be performed successfully with low-pressure pneumoperitoneum, ensuring no adverse complications.
Area of Science:
- Pediatric Surgery
- Gastrointestinal Surgery
Background:
- VATER association (VPS) can present complex surgical challenges.
- Laparoscopic Nissen fundoplication is a standard treatment for gastroesophageal reflux disease.
Observation:
- Two pediatric cases (13-year-old girl, 9-year-old boy) with VPS underwent successful laparoscopic Nissen fundoplication.
- A standard five-port technique with low-pressure pneumoperitoneum was utilized.
- The VPS system did not impede port placement or intraabdominal manipulation.
Findings:
- The procedure was technically successful in both pediatric VPS cases.
- No adverse complications were observed during or after the surgery.
- Low-pressure pneumoperitoneum was deemed safe and effective for advanced laparoscopic surgery in these cases.
Implications:
- Laparoscopic fundoplication is a viable and safe surgical option for pediatric patients with VPS.
- This approach minimizes invasiveness and potential complications.
- Further research into the effects of pneumoperitoneum in VPS patients is warranted but current findings support its safety.
Abstract:
We reported successful laparoscopic fundoplication in 2 pediatric cases with VPS and discuss the safety and feasibility of the procedure. Case 1: A 13-year-old girl with VPS underwent laparoscopic fundoplication. Case 2: a 9-year-old boy with VPS underwent laparoscopic fundoplication. In both cases, laparoscopic Nissen fundoplication was performed with a standard five-port technique with a low pressure of a pneumoperitoneum. The VPS system had no effect on port layout and intraabdominal manipulation and no adverse complications were observed in either case. The effect of a pneumoperitoneum in the VPS system remains controversial, however, the author emphasized that advanced laparoscopic surgery can be performed safely with creating a low pressure of a pneumoperitoneum.