#Thoracoscopic Surgery In Children in Delhi

[drprashantjain]

Thoracoscopic Surgery In Children: What Is It?

Thoracoscopic Surgery In Children: What Is It?

Thoracosopic surgery is a type of minimally invasive surgery that is appropriate for children who require surgery for a variety of chest diseases. Today, a variety of straightforward and complicated surgical chest problems are regularly treated with thoracoscopy. Small incisions allow for minimally invasive surgery, which prevents damage to the muscles and nerves of the chest wall. On the other hand, huge incisions like those utilized in open surgery are uncomfortable and may eventually result in chest wall deformities.

During a thoracoscopic surgery, to see the structures inside the chest, the surgeon uses a thorascope (a small tube with an eyepiece that the surgeon sees through during surgery) and/or an endoscope (a small video camera).

The surgeon can now do procedures that would often require big thoracotomy incisions by using an endoscope to view through them. In order to undergo surgery, patients must be put under general anaesthesia in an operating room.

What are the advantages of thoracoscopic surgery in children?

On the contrary, large incisions as used in open surgery are painful and can cause chest wall deformity in the long run. Patients who have had minimally invasive surgery report the following outcomes when compared to those of regular surgery:

Reduced postoperative discomfort

Reduction in hospital stay

Faster healing and return to work

Less bleeding and a lower chance of infection are two other advantages.

How does thoracoscopic surgery in children work?

Thoracoscopic surgery is carried out by paediatric laparoscopic surgeon. During this procedure, a small incision is made to allow the surgical team to introduce a trocar into an intercostal space. Pumping carbon dioxide into the thoracic cavity creates an interior area for the surgeon to work by separating the body wall from the organs. The surgeon next inserts a thorascope and/or endoscope to view the structures of the chest. The use of tiny instruments is made possible by a number of additional incisions or tiny ports.

For whom is minimally invasive surgery appropriate?

A minimally invasive procedure can be used to perform almost all conventional thoracic procedures.

If thoracic surgery needs to be done, a minimally invasive surgical approach is the first that is considered. However, some procedures are still best carried out using the conventional “open” method. Your surgeon will thoroughly examine you to decide the safest surgical procedure to be used to treat your ailment.

Various thoracoscopic surgery procedures:

Dr. Prashant Jain, one of the finest paediatric surgeons in Delhi, has had great success in removing chest malignancies using minimally invasive surgery. He also performs a few other procedures listed below:

Mediastinal tumor removal

Mediastinal cysts removal

Lung malformations

Empyema

Lung biopsy

Spontaneous Pneumothorax

How can I get a thoracoscopic surgery evaluation?

Your physical exam and treatment choices will be discussed when you visit the laparoscopic surgeon. He will go over the advantages and possible drawbacks of the surgery that is suggested for you.

Preoperative exams typically include:

Blood test

Pulmonary function test

MRI

Electrocardiogram

Depending on the kind of treatment being performed, your surgeon will decide if any extra preoperative testing is required. A cardiologist’s visit will be arranged if a cardiac (heart) assessment is required.

You will consult with an anesthesiologist as part of your preoperative evaluation. During this time, you will talk about postoperative pain management and anesthesia.

In Delhi, Dr. Prashant Jain is a well-known paediatric laparoscopic surgeon. Call (+91) 8766 350 320 to schedule an appointment and get all your questions answered from the expert.

Tag = Thoracoscopic Surgery In Children in Delhi, Pediatric laparoscopic surgeon in Delhi, Best pediatric surgeon in delhi

[prashantjainsblog]

Thoracosopic surgery is a type of minimally invasive surgery that is appropriate for children who require surgery for a variety of chest diseases. Today, a variety of straightforward and complicated surgical chest problems are regularly treated with thoracoscopy. Small incisions allow for minimally invasive surgery, which prevents damage to the muscles and nerves of the chest wall. On the other hand, huge incisions like those utilized in open surgery are uncomfortable and may eventually result in chest wall deformities.

You will consult with an anesthesiologist as part of your preoperative evaluation. During this time, you will talk about postoperative pain management and anesthesia.

During a thoracoscopic surgery, to see the structures inside the chest, the surgeon uses a thorascope (a small tube with an eyepiece that the surgeon sees through during surgery) and/or an endoscope (a small video camera).

The surgeon can now do procedures that would often require big thoracotomy incisions by using an endoscope to view through them. In order to undergo surgery, patients must be put under general anaesthesia in an operating room.

In Delhi, Dr. Prashant Jain is a well-known pediatric laparoscopic surgeon. Call (+91) 8766 350 320 to schedule an appointment and get all your questions answered from the expert.

Tags- Minimally invasive Surgery, Pediatric Laparoscopic Surgeon in Delhi, Thoracoscopic Surgery, Thoracoscopic Surgery in Children, Dr. Prashant Jain

[click2explore]

Consult the Best Bariatric Surgeon in Delhi

Obesity is a medical condition that happens when a person has too much weight or body fat, which can be harmful to their health. If a person has a high BMI, a doctor will usually indicate that they are obese (BMI)

What exactly is BMI?

BMI is a measure used by doctors to determine whether or not a person's weight is suitable for their age, gender, and height. It combines a person's weight in kilogrammes divided by their height in metres squared.

A BMI of between 25 and 29.9 suggests that a person is overweight. Obesity is defined as a BMI of 30 or higher.

Complication with obesity

Obesity is linked to a variety of health problems and mental health disorders. This health problem can have major effects for both afflicted individuals and their families, since it can cause respiratory difficulties like sleep apnea, diabetes, high blood pressure, various types of cancer, heart disease, high cholesterol, stroke, and fertility and pregnancy concerns. As a result, it is critical to understand the many causes of obesity and take action to alleviate them.

Cause of obesity

Lack of physical activity

Obesity is caused by a lack of movement and physical activity, as many individuals now have sedentary lifestyles because of longer work hours and leisure time spent sitting down.

Comfort eating

Obesity can also be caused by excessive intake of fast food and unhealthy, high-calorie meals, as well as excessive alcohol use, sugary drinks, and comfort eating.

Genetics

Children of obese parents are more likely to be obese themselves, thus genetics can also play a role.

Unbalanced hormones

Stress and lack of sleep can induce hormonal imbalances, which can lead to cravings and overeating.

Medications

Steroids, beta-blockers, antidepressants, seizure drugs, and diabetes medications can all contribute to weight gain and obesity.

Prevent obesity

To manage obesity, it is vital to lower energy intake and increase physical activity. If these strategies do not work, see a doctor or a qualified dietitian before making any big changes, as each person's body and needs are different. You may be a candidate for bariatric surgery if you have been diagnosed with class III obesity. Surgery is a drastic but extremely effective approach to drop significant amounts of weight over time.

VISIT BEST BRAIATRIC SURGEON IN DELHI

Dr. Tarun Mittal is connected to Sir Ganga Ram Hospital as a Consultant Surgeon with Special Expertise in Laparoscopic, Obesity, and Thoracoscopic Surgery. He is renowned as a most successful laparoscopic surgeon in Delhi, a bariatric surgeon in Delhi, as well an obesity surgeon in India.

He has performed several thousand of these surgeries with almost 100% success rate on local as well as overseas patients till date. Many Successful Surgeries have been done by him. He is also known as an expert bariatric surgeon in Delhi, NCR.

[bestpediatricsurgeoninindia]

Thoracosopic surgery, is a Minimally Invasive Surgery which uses multiple small incisions, and is suitable for children who need to undergo surgery for various chest conditions. Dr. Prashant Jain, is one of the best paediatric surgeon in Delhi (India), who has achieved excellent results in the removal of chest tumors through minimally invasive surgery.

[pedsurgerydelhi]

Thoracoscopic Surgery In Children, Paediatric Laparascopic Surgeon in Delhi, India - Dr. Prashant Jain

Thoracoscopic Surgery For Children

Thoracosopic surgery, is a Minimally Invasive Surgery which uses multiple small incisions, and is suitable for children who need to undergo surgery for various  chest conditions. Thoracoscopy is now very frequently used for various simple and complex surgical chest conditions. Since a Minimally Invasive Surgery can be done with small incisions, this avoids injury to chest wall muscles and nerves. On the contrary, large incisions as used in open surgery are painful and can cause chest wall deformity in long run. Minimally Invasive Surgery have shown great results, with lesser pain, reduced hospitalization, lesser complications and a better cosmetic result  as compared to traditional thoracotomy. However, Thoracotomy will still be needed in some select cases. Dr. Prashant Jain, is one of the best paediatric surgeon in Delhi (India), who has achieved excellent results in the removal of chest tumors through minimally invasive surgery. Following are some other procedures that he performs:

Excision of mediastinal tumors: Thoracoscopy has been found to be very useful in excision of mediastinal tumors/ masses like neuroblastoma, thymoma, teratoma etc. The advantage of thoracoscopy is it gives excellent magnified vision which helps in complete excion without damaging adjacent vital structures.

Excision of Mediastinal cysts: Various mediastinal and lung cysts can be safely removed in newborns, infants and pediatric patients with excellent results. This include bronchogenic cyst, enteric duplication cyst, thymic cyst, hydatid cyst etc. Some of these cyst are diagnosed during antenatal period.

Lung Malformations: Thoracoscopy excision of lung malformation involves CCAM, CLE and lung sequestration.

Empyema: Empyema is an infection due to pus formation in the chest cavity or the pleural space. Children with empyema requires treatment with antibiotics, thoracostomy and thoracoscpic decprtication. For thoracoscopic decortication, three to four small incisions (3-5mm) are made to access the pleural space. Following which, the pleural space is cleansed off all debris and infected material, using a camera to see inside. Thus making the lung re-expand. Thoracoscopy addresses the symptoms and aids in a faster recovery, thereby reducing the patient’s stay in the hospital, especially when it is done in the initial stages of the illness.

Lung Biopsy: Lung Biopsy is carried out for children with chronic lung conditions, which may be difficult to diagnose, even after numerous tests. The Lung Biopsy is done using three small incisions, through which, the targeted area of the lung is biopsied. Diagnosis is achieved in almost 95% of the biopsies. It eliminates the requirement a large incision and its associated complications, while providing the same amount of tissue for analysis, as that of thoracotomy. Due to limited post-operative pain, and discomfort which does not compromise respiration, this procedure is well tolerated, even in children with advanced lung disease.

Spontaneous Pneumothorax:  Pneumothorax is a life-threatening condition in which the lung collapses. Teenagers progressing through their adolescent growth spurt and children with underlying lung diseases, like apical cysts or cystic fibrosis are more prone to pneumothorax. The lungs need to be re-expanded to allow healing and removal of symptoms. Thoracoscopy is recommended for children with a recurring pneumothorax. The apical cysts (if present) are removed with an endoscopic stapling device. To carry out this procedure, three small incisions of 5mm – 12mm are made. To avoid air leaks in the future, the pleural cavity lining is abraided so that the lung adheres to the chest wall.

Dr. Prashant Jain, is a renowned Paediatric Laparascopic Surgeon in Delhi, India. To book an appointment call (+91) 8766350320.

Tag = Thoracoscopic Surgery In Children, Paediatric Laparascopic Surgeon in Delhi, best pediatric surgeon in delhi

For more information = http://www.pedsurgerydelhi.com/

[bestpediatricurologist]

Thoracoscopic Surgery In Children From Paediatric Laparascopic Surgeon in Delhi, India - Dr. Prashant Jain

Thoracoscopic Surgery For Children

Thoracosopic surgery, is a Minimally Invasive Surgery which uses multiple small incisions, and is suitable for children who need to undergo surgery for various  chest conditions. Thoracoscopy is now very frequently used for various simple and complex surgical chest conditions. Since a Minimally Invasive Surgery can be done with small incisions, this avoids injury to chest wall muscles and nerves. On the contrary, large incisions as used in open surgery are painful and can cause chest wall deformity in long run. Minimally Invasive Surgery have shown great results, with lesser pain, reduced hospitalization, lesser complications and a better cosmetic result  as compared to traditional thoracotomy. However, Thoracotomy will still be needed in some select cases. Dr. Prashant Jain, is one of the best paediatric surgeon in Delhi (India), who has achieved excellent results in the removal of chest tumors through minimally invasive surgery. Following are some other procedures that he performs:

Excision of mediastinal tumors: Thoracoscopy has been found to be very useful in excision of mediastinal tumors/ masses like neuroblastoma, thymoma, teratoma etc. The advantage of thoracoscopy is it gives excellent magnified vision which helps in complete excion without damaging adjacent vital structures.

Excision of Mediastinal cysts: Various mediastinal and lung cysts can be safely removed in newborns, infants and pediatric patients with excellent results. This include bronchogenic cyst, enteric duplication cyst, thymic cyst, hydatid cyst etc. Some of these cyst are diagnosed during antenatal period.

Lung Malformations: Thoracoscopy excision of lung malformation involves CCAM, CLE and lung sequestration.

Empyema: Empyema is an infection due to pus formation in the chest cavity or the pleural space. Children with empyema requires treatment with antibiotics, thoracostomy and thoracoscpic decprtication. For thoracoscopic decortication, three to four small incisions (3-5mm) are made to access the pleural space. Following which, the pleural space is cleansed off all debris and infected material, using a camera to see inside. Thus making the lung re-expand. Thoracoscopy addresses the symptoms and aids in a faster recovery, thereby reducing the patient’s stay in the hospital, especially when it is done in the initial stages of the illness.

Lung Biopsy: Lung Biopsy is carried out for children with chronic lung conditions, which may be difficult to diagnose, even after numerous tests. The Lung Biopsy is done using three small incisions, through which, the targeted area of the lung is biopsied. Diagnosis is achieved in almost 95% of the biopsies. It eliminates the requirement a large incision and its associated complications, while providing the same amount of tissue for analysis, as that of thoracotomy. Due to limited post-operative pain, and discomfort which does not compromise respiration, this procedure is well tolerated, even in children with advanced lung disease.

Spontaneous Pneumothorax:  Pneumothorax is a life-threatening condition in which the lung collapses. Teenagers progressing through their adolescent growth spurt and children with underlying lung diseases, like apical cysts or cystic fibrosis are more prone to pneumothorax. The lungs need to be re-expanded to allow healing and removal of symptoms. Thoracoscopy is recommended for children with a recurring pneumothorax. The apical cysts (if present) are removed with an endoscopic stapling device. To carry out this procedure, three small incisions of 5mm – 12mm are made. To avoid air leaks in the future, the pleural cavity lining is abraided so that the lung adheres to the chest wall.

For More Info.(http://www.pedsurgerydelhi.com/)

Tag  =  Thoracoscopic Surgery In Children, best pediatric surgeon in delhi, best pediatric surgeon in india, best pediatric urologist in delhi, best pediatric laparoscopy surgeon in delhi

[best-pediatric-surgeon-in-india]

Thoracoscopic Surgery For Children

Thoracosopic surgery, is a Minimally Invasive Surgery which uses multiple small incisions, and is suitable for children who need to undergo surgery for various  chest conditions. Thoracoscopy is now very frequently used for various simple and complex surgical chest conditions. Since a Minimally Invasive Surgery can be done with small incisions, this avoids injury to chest wall muscles and nerves. On the contrary, large incisions as used in open surgery are painful and can cause chest wall deformity in long run. Minimally Invasive Surgery have shown great results, with lesser pain, reduced hospitalization, lesser complications and a better cosmetic result  as compared to traditional thoracotomy. However, Thoracotomy will still be needed in some select cases. Dr. Prashant Jain, is one of the best paediatric surgeon in Delhi (India), who has achieved excellent results in the removal of chest tumors through minimally invasive surgery. Following are some other procedures that he performs:

Excision of mediastinal tumors: Thoracoscopy has been found to be very useful in excision of mediastinal tumors/ masses like neuroblastoma, thymoma, teratoma etc. The advantage of thoracoscopy is it gives excellent magnified vision which helps in complete excion without damaging adjacent vital structures.

Excision of Mediastinal cysts: Various mediastinal and lung cysts can be safely removed in newborns, infants and pediatric patients with excellent results. This include bronchogenic cyst, enteric duplication cyst, thymic cyst, hydatid cyst etc. Some of these cyst are diagnosed during antenatal period.

Lung Malformations: Thoracoscopy excision of lung malformation involves CCAM, CLE and lung sequestration.

Empyema: Empyema is an infection due to pus formation in the chest cavity or the pleural space. Children with empyema requires treatment with antibiotics, thoracostomy and thoracoscpic decprtication. For thoracoscopic decortication, three to four small incisions (3-5mm) are made to access the pleural space. Following which, the pleural space is cleansed off all debris and infected material, using a camera to see inside. Thus making the lung re-expand. Thoracoscopy addresses the symptoms and aids in a faster recovery, thereby reducing the patient’s stay in the hospital, especially when it is done in the initial stages of the illness.

Lung Biopsy: Lung Biopsy is carried out for children with chronic lung conditions, which may be difficult to diagnose, even after numerous tests. The Lung Biopsy is done using three small incisions, through which, the targeted area of the lung is biopsied. Diagnosis is achieved in almost 95% of the biopsies. It eliminates the requirement a large incision and its associated complications, while providing the same amount of tissue for analysis, as that of thoracotomy. Due to limited post-operative pain, and discomfort which does not compromise respiration, this procedure is well tolerated, even in children with advanced lung disease.

Spontaneous Pneumothorax:  Pneumothorax is a life-threatening condition in which the lung collapses. Teenagers progressing through their adolescent growth spurt and children with underlying lung diseases, like apical cysts or cystic fibrosis are more prone to pneumothorax. The lungs need to be re-expanded to allow healing and removal of symptoms. Thoracoscopy is recommended for children with a recurring pneumothorax. The apical cysts (if present) are removed with an endoscopic stapling device. To carry out this procedure, three small incisions of 5mm – 12mm are made. To avoid air leaks in the future, the pleural cavity lining is abraided so that the lung adheres to the chest wall.

 Dr. Prashant Jain, is a renowned Paediatric Laparascopic Surgeon in Delhi, India. To book an appointment call (+91) 8766350320.

Tags =  Thoracoscopic Surgery For Children, best pediatric urologist in delhi, best pediatric urologist in india, best pediatric surgeon in delhi, best pediatric surgeon in india

[bestpediatricsurgeoninindia]

Dr. Prashant Jain Provides The Treatment For Thoracoscopic Surgery In Children

Thoracoscopic Surgery For Children

Thoracosopic surgery, is a Minimally Invasive Surgery which uses multiple small incisions, and is suitable for children who need to undergo surgery for various  chest conditions. Thoracoscopy is now very frequently used for various simple and complex surgical chest conditions. Since a Minimally Invasive Surgery can be done with small incisions, this avoids injury to chest wall muscles and nerves. On the contrary, large incisions as used in open surgery are painful and can cause chest wall deformity in long run. Minimally Invasive Surgery have shown great results, with lesser pain, reduced hospitalization, lesser complications and a better cosmetic result  as compared to traditional thoracotomy. However, Thoracotomy will still be needed in some select cases. Dr. Prashant Jain, is one of the best paediatric surgeon in Delhi (India), who has achieved excellent results in the removal of chest tumors through minimally invasive surgery. Following are some other procedures that he performs:

Excision of mediastinal tumors: Thoracoscopy has been found to be very useful in excision of mediastinal tumors/ masses like neuroblastoma, thymoma, teratoma etc. The advantage of thoracoscopy is it gives excellent magnified vision which helps in complete excion without damaging adjacent vital structures.

Excision of Mediastinal cysts: Various mediastinal and lung cysts can be safely removed in newborns, infants and pediatric patients with excellent results. This include bronchogenic cyst, enteric duplication cyst, thymic cyst, hydatid cyst etc. Some of these cyst are diagnosed during antenatal period.

Lung Malformations: Thoracoscopy excision of lung malformation involves CCAM, CLE and lung sequestration.

Empyema: Empyema is an infection due to pus formation in the chest cavity or the pleural space. Children with empyema requires treatment with antibiotics, thoracostomy and thoracoscpic decprtication. For thoracoscopic decortication, three to four small incisions (3-5mm) are made to access the pleural space. Following which, the pleural space is cleansed off all debris and infected material, using a camera to see inside. Thus making the lung re-expand. Thoracoscopy addresses the symptoms and aids in a faster recovery, thereby reducing the patient’s stay in the hospital, especially when it is done in the initial stages of the illness.

Lung Biopsy: Lung Biopsy is carried out for children with chronic lung conditions, which may be difficult to diagnose, even after numerous tests. The Lung Biopsy is done using three small incisions, through which, the targeted area of the lung is biopsied. Diagnosis is achieved in almost 95% of the biopsies. It eliminates the requirement a large incision and its associated complications, while providing the same amount of tissue for analysis, as that of thoracotomy. Due to limited post-operative pain, and discomfort which does not compromise respiration, this procedure is well tolerated, even in children with advanced lung disease.

Spontaneous Pneumothorax:  Pneumothorax is a life-threatening condition in which the lung collapses. Teenagers progressing through their adolescent growth spurt and children with underlying lung diseases, like apical cysts or cystic fibrosis are more prone to pneumothorax. The lungs need to be re-expanded to allow healing and removal of symptoms. Thoracoscopy is recommended for children with a recurring pneumothorax. The apical cysts (if present) are removed with an endoscopic stapling device. To carry out this procedure, three small incisions of 5mm – 12mm are made. To avoid air leaks in the future, the pleural cavity lining is abraided so that the lung adheres to the chest wall.

Tags - Thoracoscopic Surgery In Children, best pediatric surgeon in india, best pediatric surgeon in delhi

For more information link - www.pedsurgerydelhi.com

[pedsurgerydelhi]

Thoracoscopic Surgery For Children

Thoracosopic surgery, is a Minimally Invasive Surgery which uses multiple small incisions, and is suitable for children who need to undergo surgery for various  chest conditions. Thoracoscopy is now very frequently used for various simple and complex surgical chest conditions. Since a Minimally Invasive Surgery can be done with small incisions, this avoids injury to chest wall muscles and nerves. On the contrary, large incisions as used in open surgery are painful and can cause chest wall deformity in long run. Minimally Invasive Surgery have shown great results, with lesser pain, reduced hospitalization, lesser complications and a better cosmetic result  as compared to traditional thoracotomy. However, Thoracotomy will still be needed in some select cases. Dr. Prashant Jain, is one of the best paediatric surgeon in Delhi (India), who has achieved excellent results in the removal of chest tumors through minimally invasive surgery. Following are some other procedures that he performs:

[bestpediatricurologist]

Thoracosopic surgery, is a Minimally Invasive Surgery which uses multiple small incisions, and is suitable for children who need to undergo surgery for various chest conditions. Dr. Prashant Jain, is one of the best paediatric surgeon in Delhi (India), who has achieved excellent results in the removal of chest tumors through minimally invasive surgery. For More Info.(http://www.pedsurgerydelhi.com/)

Tag = best paediatric surgeon in Delhi, Thoracoscopic Surgery In Children

[bestpediatricurologist]

Pediatric urodynamics at BLK Centre for Child Health - Dr Prashant Jain

Pediatric urodynamics at BLK Centre for Child HealthWhat is Pediatric Urodynamic study?

Pediatric urodynamic study (UDS) is a group of tests done for the assessment of how well your child’s bladder is functioning.

These tests measure-:

The functions of the bladder, urethra and pelvic floor muscles

The bladder pressures while it stores and empties urine

The urinary flow and the urethral sphincter muscle activity at the same time.

What is the function of the bladder?

The urinary bladder is a reservoir that collects the urine produced by the kidneys and then empties it at the appropriate time. This is a well-coordinated system which governs relaxation and contraction of the bladder and urethral muscles. This system functions to maintain a low pressure inside the bladder and at the same time prevents involuntary leakage of the urine.

The urodynamic study tracks the filling of the bladder and monitors the pressures inside the bladder and simultaneously it also assesses the function of the urinary sphincter muscles with the help of the electromyography (EMG) of these sphincter muscles. Once the bladder is filled it then assesses the voiding pattern.

When is a Pediatric Urodynamic study required?

There are a number of conditions which disrupt this coordination between the bladder and the sphincter muscles like -:

Anatomical abnormalities: This includes conditions with bladder outlet obstruction likePosterior Urethral Valve, urethral strictures etc. Also in children with anatomic conditions that lead to incontinence, such as bladder  exstrophy/epispadias or  anorectal malformations, urodynamic studies are recommended as soon as the diagnosis is made and after initial treatments fail to correct the incontinence. Testing helps us inguiding therapy and improves the efficiency of your child’s treatment plan.

Neurological conditions:This includes conditions like spinal cord anomalies like meningomyelocele, cord teethering etc. In these cases the studies are usually performed during the new-born period, so that therapy can be initiated as soon as possible. Studies are also needed when these children are older, if they haven’t achieved continence.

Non-neurological conditions like – Neurogenic bladder, voiding dysfunction, incontinence etc. Through these tests we not only diagnose the bladder function problems in the children and also helps us determine the best way to treat the urologic condition, whether through medication, behavioral therapy, surgery or a combination of these. Additionally, through this study, we can also determine the response to the therapy initiated.

How is the study done?

During the procedure, your child will lie on an exam table for the test. Your child’s genital area will be exposed and cleansed to prepare for the catheters to be placed. A special tube called a urinary transducer catheter is put into your child’s urinary passage. It has two tubes on the other end and through one tube your child’s bladder will be filled with normal saline by the UDS machine. The other tube monitors the pressure in the bladder, which is displayed on the UDS machine.

Another small tube will be put into your child’s rectum. This measures rectal pressure during the test. The rectum pushes on the bladder and this can affect bladder pressure.

Having these tubes inserted can be uncomfortable, but it should not hurt. Your child will also have stickers called electrodes gently stuck to the buttocks and hip. The electrodes let us assess your child’s pelvic floor muscles when the bladder is being filled.

During the test, your child may have a feeling of fullness or pressure, similar to what they would feel before urinating with a full bladder. There may be some discomfort when the urinary and rectal tubes are put in and taken out. Your child may have the urge to urinate or have a bowel movement. These feelings will be less if your child is more relaxed. So we counsel the child and the parents before the study, additionally it also helps if the child is viewing his favourite show on a tablet or a mobile phone.

There are 3 phases of the study-:

Voiding phase: Urinary flow rate (also known as the Uroflowmetry)- Your child will be asked to urinate in a special toilet that is attached to a computer that records the actual flow of urine. It measures second-by-second flow and the total volume of urine.

Cystometrogram (CMG): The bladder is filled with warm normal saline through the catheter and, during the filling the computer or the UDS machine monitors the pressures. When the bladder is full, your child will need to urinate with the catheter in place so that the computer can continue to record pressures. This lets doctors monitor bladder pressures, during voiding as well.

Patch Electromyogram (EMG): The patches which are applied to your child’s buttocks will monitor the pelvic floor muscles during the bladder filling and voiding. This is simultaneously recorded by the UDS machine.

Needle Electromyogram (EMG): If your pediatric urologist suspects a neurological cause for your child’s condition, a needle EMG will likely be recommended, which gives an accurate idea about the specific urinary sphincter muscles. For this part of the test, a needle electrode is placed into the external urinary sphincter muscle. The EMG machine will record your child’s sphincter muscle reflexes and responses when the bladder is filled and emptied.

How to prepare for the study?

It is important to prepare your child, explaining why the test is important, what it is designed to accomplish and how it might improve your child’s health. Understanding the purpose of the test and all of its aspects is likely to make the testing easier for your child.

The test will not be done if the child has a urinary tract infection and is showing symptoms, so it should be treated before the test and also the test is performed under the cover of antibiotics.

Your child can eat and drink as usual before the test.

If possible, please encourage your child to have a bowel movement on the morning of the test. We usually give medications 1 or 2 days before the test to make sure that the child has an empty rectum. If the child is on a bowel management program then it needs to be completed the evening before or early morning on the day of the test. Constipation can affect the accuracy of the test.

You need to give all the medications the child is taking and also to get all the previous investigation reports.

What happens after the test?

When the test is complete, all the tubes and sticky pads will be removed. Your child may have some burning when they urinate after the test. This is normal and should improve the more often your child urinates. It should go away within 24 hours. Make sure your child drinks plenty of fluids. If your child is having any pain, you may give Crocin. A warm bath or shower may also help if they are having discomfort when they urinate.

When are the results of the tests available?

The tests are performed in the urodynamic suite, which have all the equipment installed there, along with the private toilet which is connected to the machine. There is urodynamic technician and a urodynamic nurse who help us in performing the study. The final interpretation is given after the study and further plan of action is explained.

The division of Pediatric Surgery and Pediatric Urology at BLK Centre For Child Health takes care of Pediatric Urodynamic services to diagnose and treat bladder issues in pediatric patients.

For More Info.(http://www.pedsurgerydelhi.com/)

Tag =  hypospadias surgery in delhi, Choledochal Cyst In Children, Thoracoscopic Surgery In Children, best pediatric urologist in india

[bestpediatricurologist]

Esophageal Replacement Surgery In Children - Dr Prashant Jain

Esophageal Replacement Surgery In ChildrenIntroduction

Various conditions require esophageal replacement surgery in children. Some conditions are congenital i.e., present from the time of birth, and some others are due to trauma or injury. Various techniques are used for esophageal replacement surgery.

When Esophageal Replacement Surgery Is Required?

A healthy esophagus is required to perform various functions. It helps in the transport of food and other substances from the mouth to the stomach. It also prevents the reflux of acid and other substances back into the upper part by forming a barrier. This barrier is the lower esophageal sphincter. However, various conditions may require esophageal replacement surgery. These conditions are:

Long gap esophageal atresia: The esophagus is divided into an upper esophagus and lower esophagus. When the gap between the upper and lower esophagus is large, the condition is known as long gap esophageal atresia. This condition requires immediate medical intervention.

Caustic strictures: Caustic esophageal stricture occurs when the child accidentally ingests caustic substances such as strong alkali. This condition is not very common in the adult population.

Peptic strictures: People with severe gastroesophageal reflux disease are prone to peptic strictures. The acid reflux causes scars and narrows the esophagus.

Anastomotic strictures: When the surgery is done to repair esophageal conditions such as esophageal achalasia, it may result in anastomotic strictures like esophageal stenosis.

Tumors: The doctor may perform esophageal replacement surgery to remove the cancerous tissue or tumors.

Tracheoesophageal fistula: The trachea is the tube that assists in passing the air to the lungs. It is a part of the respiratory system. The esophagus is a part of the digestive system. In the tracheoesophageal fistula, there is a connection between these two tubes. This results in the passing of food into the lungs. It may result in aspiration.

Epidermolysis bullosa: It is a rare genetic disease that may result in blistering of mucus membrane and skin. This disease may result in esophageal strictures.

Prolong impaction: Prolonged impaction of foreign objects such as radiolucent substances may cause damage and requires esophageal replacement surgery.

Intractable achalasia: Achalasia is the disease of the muscles associated with the lower esophageal sphincter. In this condition, the patient experiences difficulty swallowing, pain in the chest, and food and fluid regurgitation.

Strictures due to HIV infections: HIV infections may result in ulcerative esophagitis, which may sometimes result in esophageal strictures.

Esophagitis due to chemotherapy: Chemotherapy may result in esophagitis that causes complications resulting in esophageal replacement.

What Are The Ideal Requirements For New Esophageal Passage?

Following are the requirements for ideal esophageal passage:

It should be easily replaced with the natural esophagus.

Does not cause any compression or respiratory problems.

Functional throughout life.

Either prevent or limit the reflux.

Helps in normal functioning such as swallowing

Does not increase the risk for malignancy.

Types Of Esophageal Replacement Surgery

There are generally four types of esophageal replacement surgery. The doctor will decide which surgery will suit you, depending upon the cause and severity of the condition.

Gastric interposition: In gastric interposition, the stomach is pulled up and connected to the upper part of the esophagus. The stomach can tolerate this pull-up because of the presence of a venous plexus and a rich network of submucosal arteries. The advantage of this technique includes the easy procedure, reduced risk of stricture, low risk of necrosis, and requires only one anastomosis. The disadvantage of this technique is that it may cause thoracic organ compression as the stomach may occupy a large area of the chest.

Gastric tube interposition: This is a highly technical and demanding procedure and is associated with postoperative complications. The surgery may be either isoperistaltic or reverse peristaltic. In this technique, the surgeon constructs the gastric tube from the greater curve of the stomach. The surgeon then connects the tube with the upper part of the esophagus. Advantages of this technique include high acid reflux and reduced size of the stomach.

Colonic interposition: It is one of the most commonly used methods for esophageal replacement. In this surgery, a part of the colon is removed and is positioned as the esophagus. The technique is relatively easy and simple and has less serious and less frequent complications.

Jejunal interposition: In this technique, the surgeon replaces the missing esophagus with a section of jejunum. This technique is generally used in redo cases. The children who have undergone surgery for esophageal achalasia repair and the surgery gets failed may undergo jejunal interposition surgery.

For More Info.(http://www.pedsurgerydelhi.com/)

Tag =  Choledochal Cyst In Children, Thoracoscopic Surgery In Children, Undescended Testis In Children, pelvi ureteric junction obstruction treatment delhi

[bestpediatricurologist]

Vesicoureteral Reflux Causes, Symptoms And Treatments - Dr. Prashant Jain

Vesicoureteral Reflux Causes, Symptoms And TreatmentsKidneys are important organ for urine formation. Normally, urine flows into the bladder through ureters. However, in some children, urine from the bladder flows back through the ureters. This condition is known as Vesicouretral reflux (VUR) and is common in infants and children. It can be unilateral or bilateral. This could cause infections and damage your kidneys. VUR affects about 10% of children. Although most can grow out of this condition, people who have severe cases may need surgery to protect their kidneys.

This condition should not be ignored as it damages the function of kidneys and can lead to high blood pressure later in life. The risk of kidney damage is greatest during the first 6 years of life.

Causes of VUR:

A flap valve is located where the ureter joins with the bladder. Usually, the valve allows only a one-way flow of urine from the ureters to the bladder. Sometımes, a defective flap valve allows urine to flow backward. This can affect one or both ureters. This is called “primary vesicoureteral reflux.”

Sometimes VUR can be because of  blockage at the bladder outlet(Posterior urethral valve or abnormality of the bladder functions (Neurogenic bladder) that can causes urine to push back into the ureters.

This back flow of urine is responsible for recurrent urinary tract infections and damage of kidney (Renal scarring).

Symptoms:

Urinary tract infection is one of the commonest presentation seen in  children younger than the age of 5.

Common symptoms are:

Foul smelling or cloudy urine

Fever

Burning or pain while urinating

Frequency and urgency of urine

Vomiting

Infants may have following symptoms.

Diarrhoea.

Poor feeding.

Fever

Increased irritability

Also ultrasound scan done during pregnancy showing swelling in kidneys can be because of VUR.

Diagnosis Of VUR:

VUR can often be suspected by ultrasound before a child is born or if child has urinary tract infection. Ultrasound may show dilatation of drainage system of kidney (Pelvi-calyceal system and ureter) called as hydronephrosis, but this does not prove that reflux is present.

VUR is diagnosed using an X-ray of the bladder known as voiding cystourethrogram (VCUG). In this procedure, a thin, soft tube (catheter) is placed in the bladder through the urethra. Dye is then introduced into the bladder through the tube. X-ray pictures are taken to see if the dye flows back into the ureters. Based upon the severity, VUR is categorized into five grades. Milder grade of VUR does not require any treatment. All infants with urinary tract infection and other older children with frequent urinary tract infections with or without hydronephrosis should a be considered for VCUG test.

Treatment Options For Management Of VUR:

There are 3 main options for managing or treating VUR. One should understand the risks, benefits, and follow-up of each treatment.

Antibiotic :It is used to prevent infections until VUR goes away by itself. This treatment may take several years, and children must take medication every day. These children need to be reassessed for VUR and  renal damage on regular basis. However, long term treatment with antibiotics may cause the bacteria to become resistant, increasing the risks of recurrent infections.

Surgery : This type of treatment cures most children. Surgery is good option for high grade reflux. This can be performed by open or laparoscopic technique.

Endoscopic treatment (Deflux Injection): In this day care procedure, the medication is injected where the ureter joins the bladder. Deflux is a safe and effective treatment for VUR. A gel is introduced into the body where the ureters meet the bladder. This procedure is performed as a day care procedure. Deflux gel is placed at the spot where the ureters connect to the bladder with the help of a small camera called a cystoscope (a type of endoscope used to view the bladder). Eventually, new tissue grows around the gel, preventing the reflux of urine. Usually, there will be no pain after the procedure. Deflux is used for the treatment of all grades of VUR in children. Many children have success after one injection; while some may need more injection procedures. However lower the grade of VUR, the better it works. Also, the procedure works better for children who have reflux in only one ureter.

[drprashantjain]

Thoracosopic surgery, is a Minimally Invasive Surgery which uses multiple small incisions, and is suitable for children who need to undergo surgery for various  chest conditions. Thoracoscopy is now very frequently used for various simple and complex surgical chest conditions. Since a Minimally Invasive Surgery can be done with small incisions, this avoids injury to chest wall muscles and nerves. On the contrary, large incisions as used in open surgery are painful and can cause chest wall deformity in long run.