Operative Technique in Neonates and Infants

1. Front Matter

   Pages I-VIII

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2. Dedication: In Honor of Professor Waldemar Christian Hecker

   • Thomas A. Angerpointner

   Pages 1-3

3. Lasers in Pediatric Surgery

   • H. P. Berlien, G. Müller, J. Waldschmidt

   Pages 5-22

4. The Neodymium YAG Laser in Surgery of Parenchymatous Organs in Childhood

   • P. P. Schmittenbecher

   Pages 23-31

5. Haemostasis in Injuries of Parenchymatous Organs by Infrared Contact Coagulation

   • T. A. Angerpointner, K. L. Lauterjung, A. Hoffecker

   Pages 32-38

6. The Shaw Haemostatic Scalpel in Paediatric Surgery: Clinical Report on 3000 Operations

   • U. G. Stauffer

   Pages 39-47

7. Liver Resection with the Sonocut Ultrasonic Knife

   • B. Thomasson, L. Hedenborg, H. Wiksell

   Pages 48-57

8. Electroresection with a New Endotracheally Applicable Resectoscope

   • W. Geissler, K. Körner, P. Wurnig

   Pages 58-67

9. Experimental Studies on Caustic Burns of the Stomach by Aggressive Chemicals

   • J. Wit, L. Noack, K. Gdanietz, K. Vorpahl

   Pages 68-70

10. Intraperitoneal Application of Fibrinogen Gluing in the Rat for Adhesions Prophylaxis

    • J. L. Koltai, A. Gerhard

    Pages 71-80

11. Surgical Techniques in Short Bowel Syndrome

    • K. L. Waag, K. Heller

    Pages 81-89

12. Small Bowel Transplantation: Report of a Clinical Case

    • E. Deltz, W. Mengel, H. Hamelmann

    Pages 90-96

13. Deep Anterior Resection with Circular Stapled Anastomosis of Congenital Megacolon: Clinical Results

    • P. Dohrmann, W. Mengel, H. Schaube

    Pages 97-102

14. Secondary Sagittal Posterior Anorectoplasty

    • A. M. Holschneider

    Pages 103-117

15. Total Correction of Complete Atrioventricular Canal: Surgical Technique and Analysis of Long-Term Results

    • A. E. Urban

    Pages 118-122

16. Nonosseous Lesions of the Anterior Cruciate Ligaments in Childhood and Adolescence

    • R. Kellenberger, L. von Laer

    Pages 123-131

17. Treatment of Achalasia by the Endoscopic-Pneumatic Dilatation Method

    • P. Dohrmann, W. Mengel

    Pages 132-137

18. Back Matter

    Pages 139-143

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In conventional partial resection of parenchymatous organs significant bleeding is one of the main problems, especially in neonates and infants. The patients rapidly lose considerable amounts of their small blood volume. Laser light leads to photo­ thermal effects in tissue and causes coagulation, drying up, carbonization and evaporization, depending on the temperature. The neodymium Y AG laser emits nonvisible light in the near infrared with a wavelength of l. 0611m. This wavelength implies a relatively deep penetration into the tissue. This laser system, properly a coagulation laser, achieves its cutting effect by its high power density [9]. Because of thermal radiation in all directions, both sides of the section plane are coagulated as a positive side effect. Thus, in parenchymatous organs a combination of resection and sealing of the cut vessels and ducts, up to a limited diameter, is obtained. Laser Instruments We use a neodymium-YAG laser mediLas 2 (MBB-Medizintechnik, D-8012 Ottobrunn, Federal Republic of Germany), wavelength l. 0611m, maximal power output around 110 W (Fig. 1). Normally we prefer to work without tissue contact, Fig. l. The Nd-YAG laser system mediLas 2 with maximal power output around 100 W The Neodymium Y AG Laser in Surgery of Parenchymatous Organs 25 Fig. 2. The focusing handpiece with focal distance of 50 mm 1cm Fig. 3.

• Endoscopic Pneumatic Dilatation
• Fibrinogen Gluing
• Neodymium YAG Laser
• Resectoscope
• Small Bowel Transplantation
• Ultrasonic Knife
• endoscopy
• Laser
• surgery
• transplantation

• Munich 2, Federal Republic of Germany

  Thomas A. Angerpointner

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