Pediatric Colorectal Surgery: Tips & Tricks

Book Description

Based on 30 years of experience as a surgeon working in the field of pediatric colorectal and pelvic reconstructive surgery, author Marc Levitt shares the tips and tricks that he has developed to make operations and patient management easier and reproducible. This book teaches these skills to achieve positive results.

Patients with anorectal malformations (ARMs), Hirschsprung disease (HD), fecal incontinence from a variety of conditions, colonic motility disorders, and a myriad of other conditions comprise the field of pediatric colorectal and pelvic reconstruction. Such patients require care throughout their lives from specialists across numerous fields, which may include colorectal surgery, urology, gynecology, and GI motility, as well as specialized nursing, orthopedics, neurosurgery, anesthesia, pathology, radiology, psychology, social work, and nutrition.

Sometimes the field can seem chaotic and unpredictable. Reconstruction requires creativity and at times it feels that artwork is being created during the actual operation with no pre-plan in mind. Marc Levitt and his colleagues have worked very hard to counter that feeling, to be fully prepared, and to develop protocols, techniques, and processes that can be adopted by other clinicians, so that optimal results for patients can be achieved. This book reflects both this experience and this approach.

Table of Contents

Part I: Anorectal and Cloacal Malformations

1. Newborn Anorectal Malformations

2. Predictors of Continence

3. Operative Decision Making

4. Operative Techniques

5. Anal Stenosis, Rectal Atresia, and Presacral Mass

6. Cloaca

7. Postoperative Care of a PSARP Incision

8. Rare Cases

9. Anorectal Malformation Myths

Part II: Hirschsprung Disease

10. Diagnosis

11. Pull-Through

12. Total Colonic Hirschsprung Disease

13. Late Diagnosis Hirschsprung Disease

14. Hirschsprung Disease Myths

Part III: Functional Constipation and Fecal Incontinence

15. Bowel Management

16. Evaluation of Constipation and Surgical Adjuncts

17. Malone Appendicostomy (Antegrade) or Enemas (Retrograde) for Colonic Cleaning

18. Malone Complications and Troubleshooting

19. Laxatives

20. Thickening the Stool with Fiber

21. Bacterial Overgrowth

22. Sharing Tissues

23. Functional Constipation and Fecal Incontinence Myths

Part IV: Post-PSARP and Post-HD Pull-Through Problems

24. Problems after PSARP

25. Deciding When to Do a Redo Procedure in ARM

26. Problems after an HD Pull-Through

27. Deciding When to Do a Redo Procedure in HD

Part V: Miscellaneous Colorectal Topics and Techniques

28. Operating Room Setup and Positioning

29. Stomas

30. Ischiorectal Fat Pad

31. Miscellaneous Colorectal Conditions