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[Minimally invasive surgery in newborns weighing less than 2,500 g].
[congenital diaphragmatic hernia]
Newborns
(
NB
)
represent
a
surgical
challenge
for
the
surgeon
due
to
their
physiological
characteristics
and
reduced
surgical
spaces
.
During
the
last
decade
,
minimally
invasive
surgery
(
MIS
)
has
been
adopted
as
a
treatment
for
this
group
of
patients
.
To
report
our
experiences
of
MIS
on
NB
weighing
less
than
2
,
500
grams
.
A
retrospective
descriptive
study
was
conducted
analyzing
the
records
of
newborns
weighing
less
than
2
,
500
g
and
subjected
to
MIS
between
April
,
2009
and
2012
.
No
patients
were
excluded
.
25
newborns
participated
on
this
study
;
among
the
treated
conditions
,
congenital
diaphragmatic
hernia
(
1
)
,
Esophageal
Atresia
(
4
complete
repairs
and
2
fistula
ligation
)
,
duodenal
obstruction
(
7
)
,
Gastroesophageal
reflux
disease
(
6
Nissen
procedures
,
4
including
gastrostomy
)
,
Laparoscopic
gastrostomy
(
2
)
Intestinal
obstruction
(
two
bowel
resections
,
end
to
end
anastomosis
)
,
and
Hypertrophic
pyloric
stenosis
(
1
)
.
The
average
weight
was
1
,
920
g
(
1
,
300
-
2
,
490
g
)
and
10
of
the
infants
were
preterm
newborns
.
3
mm
instruments
were
used
,
5
mm
optic
30
°
.
Neither
intraoperative
complications
nor
conversions
were
observed
.
A
patient
with
tracheoesophageal
atresia
presented
a
fistula
at
the
site
of
anastomosis
with
spontaneous
resolution
.
MIS
has
revolutionized
surgery
,
resulting
in
less
intestinal
adhesions
,
postoperative
pain
,
shorter
hospital
stays
and
better
aesthetic
results
.
Due
to
the
availability
of
smaller
size
materials
,
these
procedures
could
be
performed
safely
.
Diseases
Validation
Diseases presenting
"bowel resections"
symptom
congenital diaphragmatic hernia
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