By Iain Yardley (auth.), Prof. Dr. Robert Carachi, Dr. Sandeep Agarwala Additional Professor, Tim J. Bradnock, Prof. Hock Lim Tan, Salvatore Cascio (eds.)
This distinctive guide is a “surgical cookbook” designed to supply transparent and concise counsel for trainees in pediatric surgical procedure. by way of uncomplicated line drawings depicting every one operative step, multiple hundred usually played techniques are defined and confirmed. The reader will easy methods to practice each one strategy successfully and accurately, warding off power issues. the entire variety of surgical procedure is roofed, together with easy surgical abilities, day surgical procedure tactics, emergency surgical procedure tactics and minimally invasive surgical procedure. The publication may be of price not just to trainees in pediatric surgical procedure but in addition to trainees mostly surgical procedure, theatre nurses, mom and dad and carers.
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Extra resources for Basic Techniques in Pediatric Surgery: An Operative Manual
Discuss this with the patient’s cardiologist preoperatively. If monopolar diathermy must be used, ensure there is a defibrillator in theatre and site the diathermy plate as near to the active electrode as possible. Bipolar diathermy is a safer option in this scenario. A5 Diathermy In patients with cochlear implants, the current may be transmitted through the device, permanently damaging the device or the patient’s own cochlear tissues. Monopolar diathermy must not be used on the head and neck, and bipolar may only be used with certain types of implants.
Closure Closure is as described for the bilateral subcostal incision with additional closure of the linea alba by using a slowly absorbed material such as polydioxanone or nylon. Fig. 4 Fig. 5 46 T. J. Bradnock and R. Carachi Tips 77 77 77 Always use your assistant to best advantage to apply tension across the tissue being divided. The divided rectus abdominus is held by tendinous intersections superiorly and inferiorly to the incision and retracts very little. Only the rectus sheath requires closure.
2 Fig. 3 • Typically closure is done in layers with absorbable sutures (2/0 to 4/0, depending on the age of the child). • Use curved mosquito forceps to grasp peritoneum, transversalis muscle/fascia and posterior rectus fascia, at the apices of the wound and on both sides, halfway along. Close this layer with a continuous absorbable suture. • Use a continuous absorbable suture to close anterior rectus fascia. • Close the internal and external oblique muscles in separate, continuous layers. • Use interrupted absorbable sutures to close Scarpa’s fascia.