Merrill McHoney Edward M. Kiely Imran Mushtaq Editors Color Atlas of Pediatric Anatomy, Laparoscopy, and Thoracoscopy 123 Color Atlas of Pediatric Anatomy, Laparoscopy, and Thoracoscopy Merrill McHoney • Edward M. Kiely Imran Mushtaq Editors Color Atlas of Pediatric Anatomy, Laparoscopy, and Thoracoscopy Editors Merrill McHoney Imran Mushtaq Paediatric Surgery Great Ormond Street Hospital for Children Royal Hospital for Sick Children Edinburgh London, United Kingdom Edinburgh, United Kingdom Edward M. Kiely Great Ormond Street Hospital for Children London, United Kingdom ISBN 978-3-662-53083-2 ISBN 978-3-662-53085-6 (eBook) DOI 10.1007/978-3-662-53085-6 Library of Congress Control Number: 2017930186 © Springer-Verlag Berlin Heidelberg 2017 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Printed on acid-free paper This Springer imprint is published by Springer Nature The registered company is Springer-Verlag GmbH Germany The registered company address is: Heidelberger Platz 3, 14197 Berlin, Germany Foreword This beautifully illustrated Atlas will, I believe, prove invaluable to paediatric surgeons at all stages of their career. Those who are already proficient in minimal access surgery will find it useful in planning a new procedure as well as rehearsing more familiar ones. Trainees will benefit from it as they develop their surgical skills. Many paediatric surgeons have been slow to adopt minimal access techniques, continuing to perform “conventional” open surgery for most procedures. This book will hopefully stimulate those yet to be convinced, to ensure that they acquire the appropriate skills and adopt these techniques. The authorship of this Atlas is international, from the United States, Europe, the Far East, and the United Kingdom, including, I am proud to note, several from Edinburgh, one of the first paediatric centres in the United Kingdom to pioneer these techniques. The operative stages of each procedure are clearly illustrated in a step-by-step sequence to aid understanding and facilitate successful completion of the entire operative procedure endoscopically. Endoscopic surgery, mainly laparoscopy and thoracoscopy, not only offers benefit to the patient (improved cosmesis, less pain, less post-operative ileus, shorter hospital stay, faster recovery, etc.), but it is also advantageous to the surgeon. The view of the operative site, as seen in this Atlas, is usually far superior to that obtained through an open incision. The light is better and the magnification of the image on the screen gives a much clearer view of the detailed anatomy. I am certain that the next generation of paediatric surgeons will look back and say, “Did they really make those large, unsightly and disfiguring incisions when the same proce- dure can easily be performed using minimal access techniques?” “In the 21st century it is unacceptable to perform any surgical procedure on a child by the open route if it can be safely and easily be carried out through minimal access surgery” (MacKinlay GA, BAPS Liverpool 1999). When I made this statement, it was considered heret- ical, but increasingly in the past two decades, the minimally invasive approach has evolved into routine paediatric surgical practice. This volume will likely become an essential component of every paediatric surgical department. Edinburgh, UK Gordon A. MacKinlay v Preface We have been privileged to have worked with trainers and colleagues who have encouraged the development of minimally invasive surgery in children. The popularity of minimally invasive surgery in children is increasing, as well as the need for an atlas to help with the step-by-step approach to common operations, not only for those who are learning but also more advanced practitioners needing refreshing pictorial tips or reminders. This is not a textbook with details of disease pathology, clinical presentation, or even indications for surgery for each procedure. Instead, this atlas purely focuses on the operative steps once these steps have already been achieved. The impetus to edit this book has come from our desire to help students, trainees, and colleagues in developing minimally invasive surgery in children. We hope that this atlas will be of value to those who are developing those skills. vii Contents 1 Introduction and General Principles . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 Merrill McHoney, Edward Kiely, and Imran Mushtaq 2 Equipment and Ergonomics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9 Alex C. H. Lee and Hugh W. Grant 3 Thoracoscopic Debridement of Empyema . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27 Fraser D. Munro, Merrill McHoney, and Malcolm Wills 4 Spontaneous Pneumothorax . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 31 Merrill McHoney and Michael Singh 5 Thoracoscopic Lung Biopsy and Segmentectomy . . . . . . . . . . . . . . . . . . . . . . . . . . 39 Kokila Lakhoo 6 Thoracic Sympathectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 45 Giampiero Soccorso and Michael Singh 7 Thymectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 49 Melissa Short and Dakshesh H. Parikh 8 Mediastinal Cysts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55 Michael Singh 9 Thoracoscopic Nuss Procedure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59 Joanna Stanwell and Robert Wheeler 10 Esophageal Atresia and Tracheoesophageal Fistula . . . . . . . . . . . . . . . . . . . . . . . . 65 Merrill McHoney, Fraser Munro, Jimmy Lam, and Gordon MacKinlay 11 Thoracoscopic Aortopexy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 Joanna Stanwell and Edward Kiely 12 Thoracoscopy for Congenital Lung Malformations . . . . . . . . . . . . . . . . . . . . . . . . 81 Fraser D. Munro 13 Thoracic Neuroblastoma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89 Michael Singh and Giampiero Soccorso 14 Thoracoscopic Placation for Eventration of the Diaphragm . . . . . . . . . . . . . . . . . 93 Ashok Daya Ram and Michael Singh 15 Laparoscopic Repair of Morgagni Hernia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 Michael Singh 16 Primary Button Gastrostomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 103 Clarie Clark 17 Nissen Fundoplication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109 Merrill McHoney ix x Contents 18 L aparoscopic Thal Fundoplication . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119 Khaled Ashour, Alex C.H. Lee, and Hugh W. Grant 19 P yloric Stenosis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125 Merrill McHoney 20 D uodenal Atresia Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 133 Aimee Gibson and Nada Sudhakaran 21 M eckel Diverticulum . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143 Brian MacCormack and Philip Hammond 22 L aparoscopic Appendectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147 Shabnam Parkar and Simon A. Clarke 23 L aparoscopy for Intussusception . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161 Kate Cross 24 Laparoscopic Cholecystectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165 Augusto Zani and Niyi Ade-Ajayi 25 Laparoscopic Splenectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 173 Khalid Elmalik and Sean Marven 26 Laparoscopic Surgery for Choledochal Cysts . . . . . . . . . . . . . . . . . . . . . . . . . . . . 183 Nguyen Thanh Liem 27 Laparoscopic Colectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 189 Maurizio Pacilli and Hugh W. Grant 28 Laparoscopic Duhamels Pullthrough for Hirschprung Disease . . . . . . . . . . . . . . 201 Merrill McHoney 29 Laparoscopic-Assisted Soave Pullthrough for Hirschsprung Disease . . . . . . . . . 211 Amanda J. McCabe 30 Laparoscopic-Assisted Swenson-Like Transanal Pullthrough for Hirschsprung Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 225 Michael Stanton, Bala Eradi, and Marc A. Levitt 31 Inguinal Hernia Repair . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 235 Merrill McHoney 32 Undescended Testis: Laparoscopic Fowler-Stephens Orchidopexy . . . . . . . . . . . 241 Francisca Yankovic and Naima Smeulders 33 Laparoscopic Varicocelectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 253 Vassilis J. Siomos, Cole Wiedel, and Duncan T. Wilcox 34 Retroperitoneoscopic Adrenalectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259 Imran Mushtaq and Francisca Yankovic 35 Laparoscopic Nephrectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 265 Pankaj Kumar Mishra and Abraham Cherian 36 Retroperitoneoscopic Nephrectomy/Heminephrectomy . . . . . . . . . . . . . . . . . . . . 271 Jimmy Lam 37 Pyeloplasty . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 279 Harish Chandran Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291 Contributors Niyi Ade-Ajayi Department of Paediatric Surgery, King’s College Hospital NHS Foundation Trust, London, UK Khaled Ashour Department of Paediatric Surgery, John Radcliffe Hospital, Oxford University, Oxford, UK Harish Chandran Department of Paediatric Surgery and Urology, Birmingham Children’s Hospital, Birmingham, UK Abraham Cherian Department of Paediatric Urology, Great Ormond Street Hospital, London, UK Melanie Claire Clark Royal Hosptial for Sick Children, Edinburgh, UK Simon A. Clarke Department of Pediatric Surgery, Chelsea and Westminster NHS Foundation Trust, London, UK Kate Cross Paediatric Surgery Department, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK Khalid Elmalik Sheffield Children’s Hosptial, Sheffield, UK Bala Eradi Department of Paediatric Surgery, Leicester Royal Infirmary, Leicester, UK Aimee Gibson Paediatric Surgery, Gold Coast University Hospital, Queensland, Australia Hugh W. Grant Department of Paediatric Surgery, John Radcliffe Hospital, Oxford University Hospitals, Oxford, Oxfordshire, UK Philip Hammond Royal Hosptial for Sick Children, Edinburgh, UK Kokila Lakhoo Department of Paediatric Surgery, Oxford Children’s Hospital, Oxford University Hospitals and University of Oxford, Oxford, UK Jimmy Lam Department of Paediatric Surgery, Royal Hospital for Sick Children, Edinburgh, UK Alex C.H. Lee Department of Paediatric Surgery, Oxford University Hospitals NHS Trust, Level 2, Oxford Children’s Hospital, John Radcliffe Hospital, Oxford, UK Marc A. Levitt The Ohio State University, Columbus, OH, USA Nationwide Children’s Hospital, Columbus, OH, USA Nguyen Thanh Liem Vinmec International Hospital, Hanoi, Vietnam Brian MacCormack Department of Paediatric Surgery, Royal Hospital for Sick Children, Edinburgh, UK Gordon A. MacKinlay Royal Hospital for Sick Children, Edinburgh, UK Sean Marven Sheffield Children’s Hostpial, Sheffield, UK xi xii Contributors Amanda J. McCabe Department of Paediatric Surgery, Royal Hospital for Sick Children, Edinburgh, UK Merril McHoney Department of Paediatric Surgery, Royal Hospital for Sick Children, Edinburgh, UK Pankaj Kumar Mishra Department of Paediatric Urology, Great Ormond Street Hospital, London, UK Fraser D. Munro Department of Paediatric Surgery, Royal Hospital for Sick Children, Edinburgh, UK Maurizio Pacilli Department of Paediatric Surgery, Oxford University Hospital, Oxford, UK Dakshesh H. Parikh Department of Paediatric Surgery, Birmingham Children’s Hospital NHS FT, Birmingham, UK Shabnam Parkar Department of General Paediatric Surgery, Chelsea Children’s Hospital, Chelsea and Westminster Hospital, London, UK Ashok Daya Ram Department of Paediatric Surgery, Birmingham Children’s Hospital, Birmingham, UK Melissa Short Department of Paediatric Surgery, Birmingham Children’s Hospital, Birmingham, UK Michael Singh Department of Paediatric Surgery, Birmingham Children’s Hospital, Birmingham, England Vassilis J. Siomos Department of Surgery-Urology, University of Colorado Hospital, Children’s Hospital Colorado, Aurora, CO, USA Naima Smeulders Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK Giampiero Soccorso Birmingham Children’s Hospital NHS Foundation Trust, Birmingham, UK Michael Stanton Department of Paediatric Surgery, G Level, Southampton Children’s Hospital, Southampton, UK Joanna Stanwell Department of Paediatric Surgery, University Hospital Southampton NHS Foundation Trust, Southampton, UK Nada Sudhakaran Paediatric Surgery, Gold Coast University Hospital, Queensland, Australia Robert Wheeler University Hospital Southampton NHS Foundation Trust, Southampton, Hampshire, UK Cole Wiedel Department of Surgery-Urology, University of Colorado Denver School of Medicine, University of Colorado Hospital, Children’s Hospital Colorado, Aurora, CO, USA Duncan T. Wilcox Department of Pediatric Urology, Children's Hospital Colorado, Aurora, CO, USA Malcolm Wills Department of Cardiothoracic Surgery, Royal Infirmary of Edinburgh, Edinburgh, UK Francisca Yankovic Department of Paediatric Urology, Great Ormond Street Hospital NHS Foundation Trust, London, UK Augusto Zani Division of General and Thoracic Surgery, The Hospital for Sick Children, Toronto, ON, Canada