WHATS NEW

Developments and Progress

Paediatric Laparoscopy.

Minimally invasive laparoscopic techniques are now having as big an effect in paediatric surgery as they have done in adult surgery. The use of 5mm and 3mm ports is now commonplace with many techniques well established. Laparoscopy is particularly suited for appendectomy, high orchidopexy, and nissen fundoplication for oesophageal reflux. For children with surgical faecal incontinence laparoscopic appendocaecostomy where the appendix tip is brought out onto the abdominal wall as a very small catheterizable continent stoma to allow colonic irrigations represents a major advance and has improved the lives of many kids.

Hypospadias repair.

Hypospadias repair for long segment urethral defects can present considerable problems though these defects can usually be repaired without the use of graft material. In difficult situations buccal musosal grafts from the mouth can be very effective in repairing the gap and providing excellent permanent durable repairs.

Urinary incontinence.

Urinary incontinence in a child can be an enormous social disability for that child. An aggressive approach is required by clinicians to provide accurate diagnosis and effective treatment. The recent availability of noninvasive urodynamic scanners that can be used in outpatients represents a major advance. These allow very accurate assessment of bladder volume and allow the clinician to check the ability of a child to, empty and double void urine from their bladder in an outpatient setting. This represents a considerable advance in the management of incontinent children.