Single-port tracheoscopic surgery in the fetal lamb
Identifieur interne : 001D18 ( Main/Exploration ); précédent : 001D17; suivant : 001D19Single-port tracheoscopic surgery in the fetal lamb
Auteurs : K. Papadakis [États-Unis, Belgique] ; F. I. Luks ; J. A. Deprest ; V. E. Evrard ; H. Flageole ; M. Miserez ; T. E. LerutSource :
- Journal of pediatric surgery [ 0022-3468 ] ; 1998.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
- KwdEn :
Abstract
Background/Purpose: Endoscopic fetal surgery could help avoid many of the problems associated with open fetal surgery, but the use of multiple ports may be too traumatic to the membranes. The authors describe a single-port technique of tracheoscopic surgery in the fetus. Methods: Time-dated pregnant ewes (95 to 105 days; term, 145 days) underwent midline laparotomy under general halothane anesthesia. A 5-mm-diameter balloon-tipped cannula was introduced in the uterus by Seldinger technique. A 1.2-mm semirigid mini-endoscope, fitted inside a 9F, 20° curved sheath, was introduced under continuous, low-pressure irrigation, inside the fetus' mouth, and advanced into the trachea. Results: Endotracheal procedures, including temporary (n = 11) and permanent balloon tracheal occlusion (n = 30) and placement of a barbed guide wire for endotracheal occlusion device insertion (n = 12), were performed by introducing a 1-mm diameter instrument alongside the telescope. These were successfully performed in 52 of the 53 fetuses. The rigidity of the telescope allowed controlled access to the pharynx; its curve allowed full tracheobronchial endoscopy with the fetus in utero. Conclusions: The present technique marries the control and optical quality of a rigid endoscope with the physiological curve only a flexible instrument could offer until now. The types of procedures performed with this technique illustrate its potential as a research tool; the size (1.2-mm diameter), shape, and optical qualities of the telescope should make clinical applications possible.
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Luks</name></author><author><name sortKey="Deprest, J A" sort="Deprest, J A" uniqKey="Deprest J" first="J. A." last="Deprest">J. A. Deprest</name></author><author><name sortKey="Evrard, V E" sort="Evrard, V E" uniqKey="Evrard V" first="V. E." last="Evrard">V. E. Evrard</name></author><author><name sortKey="Flageole, H" sort="Flageole, H" uniqKey="Flageole H" first="H." last="Flageole">H. Flageole</name></author><author><name sortKey="Miserez, M" sort="Miserez, M" uniqKey="Miserez M" first="M." last="Miserez">M. Miserez</name></author><author><name sortKey="Lerut, T E" sort="Lerut, T E" uniqKey="Lerut T" first="T. E." last="Lerut">T. E. Lerut</name></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">98-0352897</idno><date when="1998">1998</date><idno type="stanalyst">PASCAL 98-0352897 INIST</idno><idno type="RBID">Pascal:98-0352897</idno><idno type="wicri:Area/PascalFrancis/Corpus">000171</idno><idno type="wicri:Area/PascalFrancis/Curation">000163</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">000146</idno><idno type="wicri:doubleKey">0022-3468:1998:Papadakis K:single:port:tracheoscopic</idno><idno type="wicri:Area/Main/Merge">001D31</idno><idno type="wicri:Area/Main/Curation">001D18</idno><idno type="wicri:Area/Main/Exploration">001D18</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Single-port tracheoscopic surgery in the fetal lamb</title><author><name sortKey="Papadakis, K" sort="Papadakis, K" uniqKey="Papadakis K" first="K." last="Papadakis">K. Papadakis</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Division of Pediatric Surgery, Brown University School of Medicine</s1><s2>Providence, RI</s2><s3>USA</s3></inist:fA14><country>États-Unis</country><placeName><region type="state">Rhode Island</region></placeName></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Centre for Surgical Technologies, Katholieke Universiteit Leuven</s1><s3>BEL</s3></inist:fA14><country>Belgique</country><wicri:noRegion>Centre for Surgical Technologies, Katholieke Universiteit Leuven</wicri:noRegion></affiliation></author><author><name sortKey="Luks, F I" sort="Luks, F I" uniqKey="Luks F" first="F. I." last="Luks">F. I. Luks</name></author><author><name sortKey="Deprest, J A" sort="Deprest, J A" uniqKey="Deprest J" first="J. A." last="Deprest">J. A. Deprest</name></author><author><name sortKey="Evrard, V E" sort="Evrard, V E" uniqKey="Evrard V" first="V. E." last="Evrard">V. E. Evrard</name></author><author><name sortKey="Flageole, H" sort="Flageole, H" uniqKey="Flageole H" first="H." last="Flageole">H. Flageole</name></author><author><name sortKey="Miserez, M" sort="Miserez, M" uniqKey="Miserez M" first="M." last="Miserez">M. Miserez</name></author><author><name sortKey="Lerut, T E" sort="Lerut, T E" uniqKey="Lerut T" first="T. E." last="Lerut">T. E. Lerut</name></author></analytic><series><title level="j" type="main">Journal of pediatric surgery</title><title level="j" type="abbreviated">J. pediatr. surg.</title><idno type="ISSN">0022-3468</idno><imprint><date when="1998">1998</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Journal of pediatric surgery</title><title level="j" type="abbreviated">J. pediatr. surg.</title><idno type="ISSN">0022-3468</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Endoscope</term><term>Endoscopic surgery</term><term>Fetal diseases</term><term>Fetal therapy</term><term>Fetus</term><term>Human</term><term>Semirigid</term><term>Technique</term><term>Tracheoscopy</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Foetus pathologie</term><term>Traitement foetus</term><term>Trachéoscopie</term><term>Chirurgie endoscopique</term><term>Technique</term><term>Endoscope</term><term>Semirigide</term><term>Homme</term><term>Foetus</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background/Purpose: Endoscopic fetal surgery could help avoid many of the problems associated with open fetal surgery, but the use of multiple ports may be too traumatic to the membranes. The authors describe a single-port technique of tracheoscopic surgery in the fetus. Methods: Time-dated pregnant ewes (95 to 105 days; term, 145 days) underwent midline laparotomy under general halothane anesthesia. A 5-mm-diameter balloon-tipped cannula was introduced in the uterus by Seldinger technique. A 1.2-mm semirigid mini-endoscope, fitted inside a 9F, 20° curved sheath, was introduced under continuous, low-pressure irrigation, inside the fetus' mouth, and advanced into the trachea. Results: Endotracheal procedures, including temporary (n = 11) and permanent balloon tracheal occlusion (n = 30) and placement of a barbed guide wire for endotracheal occlusion device insertion (n = 12), were performed by introducing a 1-mm diameter instrument alongside the telescope. These were successfully performed in 52 of the 53 fetuses. The rigidity of the telescope allowed controlled access to the pharynx; its curve allowed full tracheobronchial endoscopy with the fetus in utero. Conclusions: The present technique marries the control and optical quality of a rigid endoscope with the physiological curve only a flexible instrument could offer until now. The types of procedures performed with this technique illustrate its potential as a research tool; the size (1.2-mm diameter), shape, and optical qualities of the telescope should make clinical applications possible.</div></front></TEI><affiliations><list><country><li>Belgique</li><li>États-Unis</li></country><region><li>Rhode Island</li></region></list><tree><noCountry><name sortKey="Deprest, J A" sort="Deprest, J A" uniqKey="Deprest J" first="J. A." last="Deprest">J. A. Deprest</name><name sortKey="Evrard, V E" sort="Evrard, V E" uniqKey="Evrard V" first="V. E." last="Evrard">V. E. Evrard</name><name sortKey="Flageole, H" sort="Flageole, H" uniqKey="Flageole H" first="H." last="Flageole">H. Flageole</name><name sortKey="Lerut, T E" sort="Lerut, T E" uniqKey="Lerut T" first="T. E." last="Lerut">T. E. Lerut</name><name sortKey="Luks, F I" sort="Luks, F I" uniqKey="Luks F" first="F. I." last="Luks">F. I. Luks</name><name sortKey="Miserez, M" sort="Miserez, M" uniqKey="Miserez M" first="M." last="Miserez">M. Miserez</name></noCountry><country name="États-Unis"><region name="Rhode Island"><name sortKey="Papadakis, K" sort="Papadakis, K" uniqKey="Papadakis K" first="K." last="Papadakis">K. Papadakis</name></region></country><country name="Belgique"><noRegion><name sortKey="Papadakis, K" sort="Papadakis, K" uniqKey="Papadakis K" first="K." last="Papadakis">K. Papadakis</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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