tailieunhanh - Manual Endourology - part 5

Giới thiệu - 48 bệnh nhân Tư Vấn và Sự chấp thuận - 48 Chuẩn bị trước phẫu thuật - 48 Gây mê - 48 chỉ thị - 48 Hạn chế và rủi ro - 48 Choáng - 48 dụng cụ đặc biệt - 48 Operative Kỹ thuật (Step-by-Step) - 49 mẹo và thủ thuật - 50 Chăm sóc hậu phẫu - 51 Các biến chứng | 45 5 Chapter 5 Pediatric Endoscopy Fig. . Endoscopic view after 2 months selflimited process of the bladder E . Endoscopic view ureteral orifice right side F . Ureteral groin after healing G 6 Laparoscopy for the Undescended Testicle Ulrich Humke Stefan Siemer Roland Bonfig Mark Koen Introduction - 48 Patient Counselling and Consent - 48 Preoperative Preparation - 48 Anaesthesia - 48 Indication - 48 Limitations and Risks - 48 Contraindications - 48 Special I nstruments - 48 Operative Technique Step-by-Step - 49 Tips and Tricks - 50 Postoperative Care - 51 Complications - 51 Do s - 51 Dont s - 51 References - 51 Image Gallery - 52 48 Chapter 6 Laparoscopy for the Undescended Testicle Introduction Indications Cryptorchidism is a frequent diagnosis in pediatric urology and a well-known risk for male infertility and testicular malignancy. About 20 of undescended testicles are not palpable. Although the mean age of children presented for therapy with cryptorchidism is above 3 years the ideal time-point for effective preservation of fertility is between 12 and 24 months of life. Laparoscopy has evolved in the past years as the method of choice for the diagnosis and treatment of non-palpable testes. Clear advantages of laparoscopy with regard to specificity and sensitivity have been shown compared to ultrasonography and magnetic resonance imaging in detecting intra-abdominal testes. The purposes of laparoscopy for non-palpable testes are a localization and evaluation of the missing testis b orchiopexy one- or two-stage procedure and c orchiectomy if indicated each selected alone or in combination for the individual case. All cases of non-palpable testes integrated concept of diagnostic laparoscopy combined with open surgery revision of inguinal canal with or without orchiopexy or combined with therapeutic laparoscopy staged orchiopexy or orchiectomy for intra-abdominal testes . Suspected intersex laparoscopy for diagnosis eventually biopsy and or orchiectomy . .