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  • 1
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 10 (1996), S. 659-661 
    ISSN: 1432-2218
    Keywords: Antireflux operation ; Thal procedure ; Laparoscopy ; Mentally retarded children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: An increasing number of reports indicate that Thal fundoplication is the procedure of choice in mentally retarded children. With the advent of laparoscopy, Nissen's fundoplication seems to have been repopularized. However, the choice of the operative technique should be based on the merits of the procedure itself rather than the laparoscopic feasibility. The aim of this study is to determine if laparoscopic Thal fundoplication is beneficial for mentally retarded children. Methods: Between November 1993 and 1994 laparoscopic Thal fundoplication was performed in 15 mentally handicapped children; 13 also had a feeding gastrostomy. Age varied from 1.5 to almost 17 years (mean 7 years). Mean weight was 18 kg (5–50 kg). All patients underwent an upper GI study and endoscopy as well as pre- and 3 months postoperative pH study. Indications for the procedure were reflux esophagitis in 11 and feeding problems with silent reflux in 4. Results: The laparoscopic procedure was converted in the second patient because of bleeding in the hiatus. No further procedure-related intra- or postoperative complications occurred. The mean hospitalization was 3.7 days. No symptomatic postoperative gastroesophageal reflux has been observed. All children have undergone postoperative pH studies, which displayed silent reflux in two. Gastrostomy feeding is well tolerated. Conclusion: We conclude that Thal fundoplication can be performed laparoscopically in mentally retarded children. The laparoscopic results are comparable to the open Thal procedure.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Springer
    Surgical endoscopy and other interventional techniques 9 (1995), S. 1197-1198 
    ISSN: 1432-2218
    Keywords: Antireflux operation ; Thal procedure ; Laparoscopy ; Scoliosis ; Children
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Surgical treatment of gastroesophageal reflux in severely scoliotic children can be quite bothersome because sometimes the working space between the subcostal margins, iliac crest, and spinal column is very limited; the hiatus lies extremely deep away and is frequently rotated, making exposure more difficult. The laparoscopic approach could lend the necessary extension to the surgeons' hands to reach the deep hiatus. Moreover the entrance of the ports can be adjusted to the special requirements dictated by the scoliosis. Between February and December 1994 laparoscopic Thal fundoplication was performed in five severely scoliotic children; four also had a feeding gastrostomy. There were no intraoperative complications. The laparoscopic approach allowed improved operative visibility. Mean hospital stay was 3 days. The children displayed no symptomatic postoperative gastroesophageal reflux, which was confirmed by 3 months postoperative pH study. The laparoscopic approach of fundoplication allows improved visibility and easier access to the hiatus in severely scoliotic patients in comparison to the open approach. Results so far are good.
    Type of Medium: Electronic Resource
    Location Call Number Limitation Availability
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