UPDATED TOPICS IN MINIMALLY INVASIVE ABDOMINAL SURGERY

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218 Updated Topics in Minimally Invasive Abdominal Surgery in the immediate postoperative period to vaccinate as a precaution. Then, at 1-month postoperative and according to imaging controls (Doppler sonogram or contrast CT-Scan) showing the lack of spleen viability, an antibiotic course will be started. Fig. 16. Gastropexy posterior wall suture done by one surgeon Fig. 17. Final aspect of the posterior plane of the gastropexy
Laparoscopic Gastropexy for the Treatment of Wandering Spleen With or Without Gastric Volvulus Fig. 18. Suture of the anterior plane (peritoneal-gastric) of the gastropexy 8.2.3 Postoperative care The patient can drink on the day of the surgery after the legal delays post- anesthesia. Eating can be started at D1. The patient will be kept laying down on this back the first 24 hours in order to limit shoulder pain. The convalescence will last 10 days. The patient will be asked to stop all sport activities from 1 to 3 months according to patient’s age, clinical picture and type of sports. 8.2.4 Follow-up and monitoring imaging examination Children will be seen again for a surgical consultation at M1, M4, M10, M24 and postoperative follow-up then again every 3 years until adulthood. Doppler and dynamic sonograms (on the side, standing up) are the key examinations for this follow-up. They can assess the vascularization and viability of the spleen but also make sure the sutures are adequate and discard any residual ptosis. If there is a doubt on splenic vascularization, a contrast CT-Scan will be proposed. 9. Conclusion The diagnosis of wandering spleen is extremely difficult to establish because it is such a rare condition and is clinically nonspecific. Early diagnosis and surgical care are the best guarantees for preserving the spleen. Additional imaging examinations, especially abdominal sonogram as the imaging examination of choice, can help establish a diagnosis when faced with an abnormal location of the spleen. Splenopexy and gastropexy are two surgical fixation approaches aiming to maintain the viable spleen in place. The results of the gastropexy procedures seem encouraging, but faced with such a small number of cases, no conclusion can be established. Gastropexy seems to avoid the risk of 219
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UPDATED TOPICS IN MINIMALLY INVASIV
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free online editions of InTech Book
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VI Contents Chapter 9 Appendicitis
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Part 1 Laparoscopic Biliary-Pancrea
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4 Updated Topics in Minimally Invas
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1. Introduction 5 Laparoscopic Live
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Laparoscopic Liver Resection 2.2.1
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Laparoscopic Liver Resection of 64
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Laparoscopic Liver Resection conver
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Laparoscopic Liver Resection (Bruix
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Laparoscopic Liver Resection (Buell
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Laparoscopic Liver Resection House,
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1. Introduction 6 Hilar Glissonean
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Hilar Glissonean Access in Laparosc
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1. Introduction 7 Laparoscopic Live
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Laparoscopic Liver Surgery Fig. 1.
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Laparoscopic Liver Surgery speciali
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Laparoscopic Liver Surgery 3. Imagi
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Laparoscopic Liver Surgery 5 mm por
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Laparoscopic Liver Surgery A nylon
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Laparoscopic Liver Surgery Fig. 7a.
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Laparoscopic Liver Surgery or later
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Laparoscopic Liver Surgery non rand
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Laparoscopic Liver Surgery With rap
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Laparoscopic Liver Surgery [19] Tro
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Laparoscopic Liver Surgery [51] Lai
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Laparoscopic Liver Surgery [84] Les
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Part 3 Laparoscopic Appendectomy
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Laparoscopic Hernia Repair Absorba
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Laparoscopic Hernia Repair passes t
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Laparoscopic Hernia Repair The cont
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Laparoscopic Hernia Repair 2.3.3 TA
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UPDATED TOPICS IN MINIMALLY INVASIVE ABDOMINAL SURGERY

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