KIDSURGEON

Minimal Access Surgery (MAS) in Children
Traditionally, Surgery involved making large cuts over the abdomen or chest to enter into these cavities & operate on the internal organs. Obviously, this type of surgery was associated with a lot of pain & discomfort to the child. The wounds took a long time to heal during which period the child could not move or play. Finally, the large, ugly scars resulted in psychologic issus & poor body image for the child.
 
Minimal Access Surgery (MAS, otherwise called 'Keyhole surgery') has revolutionalized both adult & pediatric surgery in the new millennium. Here, the same operations are performed by inserting small (3 to 5 millimeter size) instruments into body cavities either thru natural body orifices or thru tiny holes made on the chest or abdomen. A small but powerful telescope shows a magnified view of the internal organs (10-15 times magnified) projected on to a screen. The operation is carried out by small, delicate, special instruments. The advantages of MAS are

• Magnified view during surgery, hence more accurate surgery (especially in babies & children where the organs are very small)
• Minimal postoperative pain only
• Early recovery, early feeding
• Early return to full activity & early discharge
• The most minimal scar
• Greatly reduced chance of wound complications (like infection & wound breakdown which are common in open surgery)
• Less of post-operative adhesions
• Less long-term psychologic issues associated with scar

Laparoscopic operations in children (General Pediatric Surgery)

• Appendicectomy (including complicated appendicitis)
• Herniotomy
• Orchiopexy for nonpalpable undescended testis
• Laparoscopic intussusception reduction
• Pyloromyotomy for IHPS
• Fundoplication
• Heller-Dor operation for Achalasia
• Laparoscopic Ladd’s procedure for malrotation
• Choledochal cyst excision & reconstruction
• Laparoscopic Cystogastrostomy for pancreatic Pseudocyst
• Meckel’s diverticulectomy
• Ovarian cystectomy (including neonates)
• Diagnostic procedures and biopsies
• Laparoscopic assisted Pull-Thru operations for Hirschprung's Disease & Anoractal Malformations
• Cholecystectomy
• Splenectomy

MAS Operations in Pediatric Urology

• Laparoscopic Pyeloplasty (We have done over 150 lap pyeloplasties in infants & children as young as 1 month & 3Kg wt)
• Laparoscopic Nephrectomy/Nephroureterectomy (to remove a nonfunctioning kidney)
• Laparoscopic Ureteric Reimplantation
• Laparoscopic Pyelolithotomy (removal of kidney stones)
• Cystoscopic Fulguration of PUV (including neonates)
• Cystoscopic Deflux injection for Vesicoureteric reflux (VUR)

MAS in thoracic surgery in children
 
Thoracoscopic repair of Congenital Diaphragmatic Hernia                                                   

• Thoracoscopic repair of Diaphragmatic Eventration
• Thoracoscopic repair of mediastinal cysts (Duplication cysts & Bronchogenic cysts)
• Thoracoscopic biopsy of mediastinal masses
• Thoracoscopic Lung Biopsy
• Thoracoscopic Aortopexy
• Bronchoscopy for removal of Foreign bodies in the airway & BAL procedures