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Reduced Port Laparoscopic Surgery.

Tác giả: Mori, Toshiyuki; Dapri, Giovanni

Chủ đề:

Chủ đề: Medicine; Surgery; Laparoscopic surgery

Nhà xuất bản: Springer

Năm xuất bản: 2014

Loại tài liệu: Book

Mô tả vật lý: 521 p.

Định danh: 978-4-431-54601-6

Ngôn ngữ: en

Đọc trực tuyến

Tải tài liệu

Reduced port laparoscopic surgery is a fast-developing topic for the laparoscopic surgeon, with the emergence of a number of new techniques as well as new instruments. Edited by surgeons who have pioneered the single-incision approach, this volume provides extensive information for the beginning surgeon, examining different operation techniques and covering the advantages and pitfalls of reduced port laparoscopic surgery. In addition, the text provides the foundation for new ideas to further develop skills for the advanced laparoscopic surgeon.

Cover
Title page
Memorial Tribute to Professor Motoo Yamagata
Foreword
Preface
Contents
Contributors
Chapter 1: History of Single-Port Laparoscopic Surgery
- 1.1 Introduction
- 1.2 Transitions in SPLS
- 1.3 Gallbladder
- 1.4 Small Intestine and Colon
- 1.5 Stomach
- 1.6 Appendix
- 1.7 Liver
- 1.8 Spleen
- 1.9 Groin
- 1.10 Female Organs
- 1.11 Adrenal Gland, Kidney, Prostate
- 1.12 Gastrointestinal Tract
- 1.13 Conclusion
- References
Chapter 2: Concept of Reduced Port Laparoscopic Surgery
- 2.1 Introduction
- 2.2 Single-Incision Laparoscopic Surgery (SLS)
- 2.3 Characteristics of SLS
- 2.4 Instrumentation and Techniques in SLS
- 2.5 Needle-Scopic Surgery
- 2.6 Inception of Reduced Port Laparoscopic Surgery (RPLS)
- 2.7 Future of Minimally Invasive Surgery
- References
Chapter 3: Terminology
- 3.1 Terminology of Single-Port Laparoscopic Surgery
- 3.2 Acronyms of Single-Port Laparoscopic Surgery
- 3.3 Definition of Needlescopic Surgery
- 3.4 Terminology of Reduced Port Laparoscopic Surgery
- References
Chapter 4: Pros and Cons
- 4.1 Introduction
- 4.2 Indications and Contraindications
- 4.3 Knack of Surgical Technique
- 4.4 Tips and Tricks
- 4.5 Recommendations for RPLS
- References
Chapter 5: Access Device 1: Multiple Trocars Method
- 5.1 Introduction
- 5.2 Optical Insertion Technique
- 5.3 Alternative Trocar Placement
- 5.4 Closure
- References
Chapter 6: Access Device 2: Multi-Channel Port
- 6.1 Introduction to the Technique
- 6.2 Indications and Contraindications
- 6.3 Technique
  - 6.3.1 TriPort+ and QuadPort+
  - 6.3.2 SILS Port
  - 6.3.3 GelPOINT and GelPOINT Mini
  - 6.3.4 ENDOCONE đ, X-Cone and S-PORT đ
  - 6.3.5 OCTO Port
  - 6.3.6 The Single Port Instrument Delivery Extended Reach (SPIDER)
  - 6.3.7 EZ Access and EZ Access Oval Type
  - 6.3.10 Surgical Glove Port
  - 6.3.8 x-GATE đ
  - 6.3.9 Free Access
- 6.4 Tips and Tricks
- 6.5 Recommendations from the Author
- 6.6 Conclusions
- References
Chapter 7: Video-Endoscopes and Instruments
- 7.1 Introduction
- 7.2 Characteristics of RPLS
- 7.3 Techniques for Avoiding Clashing and Sword Fighting
  - 7.3.1 Scopes
  - 7.3.2 Trocars
  - 7.3.3 Access Ports
  - 7.3.4 Instruments for RPLS
    - 7.3.4.1 Long Instruments
    - 7.3.4.2 Articulated Instruments
    - 7.3.4.3 Bending Instruments
    - 7.3.4.4 Needle Devices
    - 7.3.4.5 Anchoring System for RPLS
- 7.4 Conclusion
- References
Chapter 8: Needlescopic Devices and Pre-bent Forceps
- 8.1 Introduction
- 8.2 Surgical Tools
  - 8.2.1 Optics (Fig. 8.1)
  - 8.2.2 Laparoscopic Instruments
  - 8.2.3 Trocar-Less Instruments
  - 8.2.4 Trocar
  - 8.2.5 Pre-bent Forceps
- 8.3 Comments
- 8.4 Conclusion
- References
Chapter 9: Different Tools
- 9.1 Introduction
- 9.2 Access Devices
  - 9.2.1 Multiple Ports Through a Single-Incision
  - 9.2.2 Improvised Access Device: The Glove Port
  - 9.2.3 Dedicated Access Devices
- 9.3 Cameras
  - 9.3.1 Rigid Laparoscope
  - 9.3.2 Flexible Endoscope
  - 9.3.3 Modified Laparoscopes
- 9.4 Retraction
  - 9.4.1 Trans-Abdominal Stay Sutures and Endoloops
  - 9.4.2 Magnetic Anchoring and Guidance System (MAGS)
  - 9.4.3 Internal Retractors
- 9.5 Instruments
  - 9.5.1 Articulating Instruments
  - 9.5.2 Curved Instruments
  - 9.5.3 Instruments for Hemostasis
  - 9.5.4 Combined Dedicated Systems
- 9.6 Summary
- References
Chapter 10: Technical Considerations
- 10.1 Introduction
- 10.2 Types and Characteristics of Access Ports
  - 10.2.1 Multiple Trocar Method (Fig. 10.2) [ 1 ]
  - 10.2.2 Multi-Channel Port Method (Fig. 10.3) [ 2 ]
- 10.3 Classification of Basic Surgical Techniques
  - 10.3.1 Parallel Technique (Fig. 10.4)
  - 10.3.2 Cross Technique (Fig. 10.5)
  - 10.3.3 Cross Hand Technique (Fig. 10.6)
- References
Chapter 11: Suturing and Knot-Tying Technique
- 11.1 Introduction to the Technique
- 11.2 Selection of the Needle Holder
- 11.3 Knot-Tying Technique in Reduced Port Laparoscopic Surgery
- Reference
Chapter 12: Single-Incision Robotic Surgery
- 12.1 Introduction
  - 12.1.1 Overview
  - 12.1.2 History
  - 12.1.3 Advantages and Disadvantages
- 12.2 Indications and Contraindications
  - 12.2.1 Indications
  - 12.2.2 Outcomes
  - 12.2.3 Contraindications
- 12.3 Description of the Technique
  - 12.3.1 Basic Structure
  - 12.3.2 Individual Components
    - 12.3.2.1 Console
    - 12.3.2.2 Access Platform
    - 12.3.2.3 Instruments
    - 12.3.2.4 Patient-Side Cart
    - 12.3.2.5 Assistance
  - 12.3.3 Procedure
    - 12.3.3.1 Cholecystectomy
    - 12.3.3.2 Colectomy
- 12.4 Tips and Tricks
- 12.5 Recommendations from the Author
- References
Chapter 13: The Umbilicus as the Access Site
- 13.1 Anatomy of the Umbilicus
- 13.2 Surgical Window to Access the Peritoneal Cavity
- 13.3 Surgical Window for Tissue Extraction
- 13.4 Methods for Single-Port Laparoscopic Surgery at the Umbilicus
- 13.5 Closure of the Opened Umbilicus
- References
Chapter 14: Cholecystectomy
- 14.1 LESS: The Evolution
- 14.2 LESS Cholecystectomy: Technique
- 14.3 LESS Cholecystectomy: Results
- 14.4 Discussion
- References
Chapter 15: Cholecystectomy with Improved Retraction
- 15.1 Introduction
- 15.2 Instruments and Devices
- 15.3 Contraindications
- 15.4 Technique
- 15.5 TCMR with One Trocar and Assisted by Two internal magnetic grasper (IMANLAP Ltd)
- 15.6 Transumbilical Cholecystectomy with Magnetic Retraction with One internal magnetic grasper: The Hybrid Method
- 15.7 Results
- 15.8 Discussion
- 15.9 Tips, Tricks and Recommendations
- 15.10 Conclusions
- References
Chapter 16: Common Bile Duct Exploration
- 16.1 Introduction to the Technique
- 16.2 Indications and Contraindications
- 16.3 Description of the Technique
  - 16.3.1 Port Arrangement and Needle Equipment
  - 16.3.2 LTCE with Needle Forceps
  - 16.3.3 LCHE with Needle Forceps
- 16.4 Tips and Tricks
  - 16.4.1 Port Arrangement and Needle Forceps
  - 16.4.2 LTCE
  - 16.4.3 LCHE
- 16.5 Recommendations from the Author
- References
Chapter 17: Distal Gastrectomy
- 17.1 Introduction
- 17.2 Indications and Contraindications
- 17.3 Technique
  - 17.3.1 Patient Positioning and Operating Room Setup
  - 17.3.2 Port Setting
  - 17.3.3 Procedure
    - 17.3.3.1 Liver Retraction
    - 17.3.3.2 Suprapancreatic Lymph Nodes Dissection
    - 17.3.3.3 The Cranial Approach
    - 17.3.3.4 Dissection of No. 5 Lymph Nodes and Division of Right Gastric Artery
  - 17.3.4 Dissection of the Suprapancreatic Lymph Nodes
    - 17.3.4.1 Dissection of No. 4d, 4sb Lymph Nodes
    - 17.3.4.2 Anastomosis
      - Billroth-I Reconstruction Using Intracorporeal Triangular Anastomotic Technique
      - Roux-en-Y Reconstruction
- 17.4 Recommendations from the Author
- References
Chapter 18: Total Gastrectomy
- 18.1 Introduction
- 18.2 Indications
- 18.3 Technique
  - 18.3.1 Positioning
  - 18.3.2 Access Device
  - 18.3.3 Liver Retraction
  - 18.3.4 Procedure
- 18.4 Tips, Tricks and Recommandations from the Author
- References
Chapter 19: Wedge Gastric and Endo-Gastric Resection
- 19.1 Introduction
- 19.2 Technique I: Extragastric Approach
  - 19.2.1 Setup
  - 19.2.2 Establishment of the Main Access Route
  - 19.2.3 Insertion of 2-mm Forceps
  - 19.2.4 Resection
  - 19.2.5 Closure of the Defect
  - 19.2.6 Tips and Tricks
    - 19.2.6.1 Turning the Stomach Over
    - 19.2.6.2 Layout of the Channels
- 19.3 Technique II: Endoluminal Approach
  - 19.3.1 Indication
  - 19.3.2 Setup
  - 19.3.3 Construction of a Temporary Gastrostomy
  - 19.3.4 BJ Needle đ (Niti On Co.) Insertion
  - 19.3.5 Resection
  - 19.3.6 Closure of the Defect
  - 19.3.7 Repair of the Gastrostomy
  - 19.3.8 Tips and Tricks
    - 19.3.8.1 Location of the Temporary Gastrostomy
    - 19.3.8.2 Gastropexy
    - 19.3.8.3 Stapler Resection
- References
Chapter 20: Antireflux Procedures
- 20.1 Introduction
- 20.2 Technique
  - 20.2.1 Patient and Team Positioning
  - 20.2.2 Beginning of RPLS
    - 20.2.2.1 Nissen Fundoplication
    - 20.2.2.2 Toupet Fundoplication
    - 20.2.2.3 End of RPLS
  - 20.2.3 Post-operative Care
- 20.3 Recommendations from the Author
- References
Chapter 21: Hepatectomy
- 21.1 Introduction to Single-Port Access (SPA) Hepatectomy
- 21.2 Indications and Contraindications for SPA Hepatectomy
- 21.3 Procedural Techniques
  - 21.3.1 Position of the Patient and Layout of the Instruments
  - 21.3.2 Insertion of a Multi-Access Port and Establishment of Pneumoperitoneum
  - 21.3.3 Mobilization of the Liver
  - 21.3.4 Transection of the Liver Parenchyma
  - 21.3.5 Hemostasis
  - 21.3.6 Completion of the Procedure
- 21.4 Tips and Tricks
  - 21.4.1 Crossed and Parallel Device Configuration
  - 21.4.2 RPS
- 21.5 Recommendations from the Author
  - 21.5.1 Laparoscope
  - 21.5.2 Multi-Access Port
- References
Chapter 22: Splenectomy
- 22.1 Introduction
- 22.2 Indications and Contraindications
- 22.3 Surgical Technique
  - 22.3.1 SPLS
  - 22.3.2 RPLS
- 22.4 Tips and Tricks
  - 22.4.1 Recommendations from the Author
- References
Chapter 23: Distal Pancreatectomy
- 23.1 Introduction
- 23.2 Indications and Contraindications
- 23.3 Techniques
- 23.4 S-DP Without Splenic Preservation
- 23.5 SLS-DP with Splenic Preservation
- 23.6 Tips and Tricks
- 23.7 Recommendations from the Author
- References
Chapter 24: Pancreatico-Jejunostomy
- 24.1 Introduction
- 24.2 Indications for LPJ
- 24.3 Specific Considerations for RPLS LPJ
- 24.4 Setup
- 24.5 Access Devices and Instrumentation
- 24.6 Retraction of Tissues
- 24.7 Operative Technique
- 24.8 Post-operative Care
- 24.9 Conclusion
- References
Chapter 25: Adrenalectomy
- 25.1 Introduction
- 25.2 Surgical Indications
- 25.3 Technique
  - 25.3.1 RPLA: Transperitoneal Approach in Supine Position
  - 25.3.2 RPLA: Retroperitoneal Approach in Prone Position
- 25.4 Conclusions
- References
Chapter 26: Right Colectomy
- 26.1 Introduction
- 26.2 Technique
  - 26.2.1 Patient and Team Positioning
  - 26.2.2 RPLS
  - 26.2.3 Post-operative Care
- 26.3 Recommendations from the Author
- References
Chapter 27: Left Colectomy
- 27.1 Introduction
- 27.2 Indications and Contraindications
- 27.3 Technique
  - 27.3.1 Patient Positioning and Operative Set-up
  - 27.3.2 Access to the Abdominal Cavity
  - 27.3.3 Operative Exposure
  - 27.3.4 Dissection of the Left Colonic Mesentery and the Mesorectum
  - 27.3.5 Ligation of the Inferior Mesenteric Vessels
  - 27.3.6 Mobilization of the Splenic Flexure
  - 27.3.7 Transection of the Rectum
  - 27.3.8 Extraction of the Specimen
  - 27.3.10 Wound Closure
  - 27.3.9 Anastomosis
- 27.4 Tips and Tricks
- 27.5 Recommendations from the Author
- References
Chapter 28: Anterior Resection of the Rectum
- 28.1 Introduction
- 28.2 Indications and Contraindications
- 28.3 Pre-operative Evaluation
- 28.4 Surgical Devices
- 28.5 Set-up
  - 28.5.1 Body Position
  - 28.5.2 Port Position
- 28.6 Surgical Procedure
  - 28.6.1 Medial-to-Lateral Approach
  - 28.6.2 Lymph Node Dissection Around the Root of the Inferior Mesenteric Artery (IMA)
  - 28.6.3 Division of the Inferior Mesenteric Vein (IMV)
  - 28.6.4 Mobilization of the Left Colon
  - 28.6.5 Mobilization of the Rectum with Total Mesorectum Excision
  - 28.6.6 Transection of the Mesorectum and Rectum
  - 28.6.7 Specimen Extraction
    - 28.6.7.1 Extraction Through the Umbilical Wound
    - 28.6.7.2 Extraction Through the Natural Orifice (Anus) by the Prolapsing Technique
  - 28.6.8 Anastomosis
- 28.7 Conclusion
- References
Chapter 29: Appendectomy
- 29.1 Introduction
- 29.2 Indications and Contraindications
  - 29.2.1 SILA Versus 3-Port Laparoscopic Appendectomy
  - 29.2.2 SILA for Complicated Appendicitis
  - 29.2.3 Indications for SILA
- 29.3 Technique
  - 29.3.1 Patient Positioning and Room Set-up
  - 29.3.2 Umbilical Port
    - 29.3.2.1 Fascial Puncture Method (Direct Access Method)
    - 29.3.2.2 Multi-Channel Port Method (Access Device Method)
    - 29.3.2.3 Glove Method (Home Made Port Method)
  - 29.3.3 Appendectomy
    - 29.3.3.1 Extracorporeal Appendectomy
    - 29.3.3.2 Intracorporeal Appendectomy
    - 29.3.3.3 Division of the Appendix
      - Endoscopic Ligation
      - Endoscopic Stapling
    - 29.3.3.4 Division of the Mesoappendix
  - 29.3.4 Normograde and Retrograde Appendectomy
  - 29.3.5 Single-port PLUS-ONE
- 29.4 Tips and Tricks
  - 29.4.1 Patient Position
  - 29.4.2 Laparoscope
  - 29.4.3 Cross-Hand Technique
- 29.5 Recommendations from the Author
  - 29.5.1 Retrospective Analysis of Our Experience
  - 29.5.2 Recommendations from the Authors
- References
Chapter 30: Incisional and Ventral Hernia Repair
- 30.1 Introduction
- 30.2 Indications and Contraindications (Table 30.1)
- 30.3 Technique
- 30.4 Tips and Tricks
- 30.5 Recommendations from the Author
- References
Chapter 31: Inguinal Hernia Repair: TEP
- 31.1 Introduction
- 31.2 Preoperative Preparation
- 31.3 Set-up (Table 31.1)
  - 31.3.1 Patient Positioning (Fig. 31.1)
  - 31.3.2 Instruments and Mesh
- 31.4 Indications
- 31.5 Surgical Techniques (Multi-channel Approach)
  - 31.5.1 Skin Incision
  - 31.5.2 Inguinal Dissection
  - 31.5.3 Lateral Inguinal Dissection
  - 31.5.4 Parietalization (Fig. 31.7)
  - 31.5.5 Mesh Insertion
  - 31.5.6 Mesh Fixation (Fig. 31.8)
  - 31.5.7 Closure
- 31.6 Conclusion
- 31.7 Recommendation from the Authors
- References
Chapter 32: Inguinal Hernia Repair: TAPP
- 32.1 Introduction
- 32.2 Indications and Contraindications
- 32.3 Technique
- 32.4 Tips and Tricks
- 32.5 Recommendations from the Authors
- References
Chapter 33: Adjustable Gastric Banding for Obesity
- 33.1 Introduction
- 33.2 Patient Selection
- 33.3 Technique
  - 33.3.1 Patient Positioning
  - 33.3.2 Port Placement
  - 33.3.3 Band Placement
  - 33.3.4 Liver Retraction
  - 33.3.5 Instruments
- 33.4 Conclusion
- References
Chapter 34: Roux-en-Y Gastric Bypass for Obesity
- 34.1 Introduction
- 34.2 Evolution of Bariatric Surgery
  - 34.2.1 Open Bariatric Surgery
  - 34.2.2 Laparoscopic Bariatric Surgery
  - 34.2.3 Reduced Port Laparoscopy and Single-Incision Laparoscopy
- 34.3 Technique
- 34.4 Surgical Results
- 34.5 Pitfalls and Their Management
  - 34.5.1 Trocar Placement
  - 34.5.2 Liver Retraction
  - 34.5.3 Instruments and Surgical Technique
    - 34.5.3.1 Fascial Closure
    - 34.5.3.2 Limitations and Contra-Indications for SLS Bariatric
- 34.6 Recommendations and Conclusions
- References
Chapter 35: Sleeve Gastrectomy for Obesity
- 35.1 Introduction to the Technique
  - 35.1.1 TANKO Bariatric Surgery Worldwide
  - 35.1.2 Objections to TANKO Bariatric Surgery
  - 35.1.3 Our Method
- 35.2 Indications and Contraindications
- 35.3 Description of the Technique and Tips and Tricks
  - 35.3.1 Set-up
  - 35.3.2 Approach
  - 35.3.3 Exposure of the Surgical Field: Liver Retraction
  - 35.3.4 Manipulation
  - 35.3.5 Scars and Results
- 35.4 Recommendations from the Author
- 35.5 Conclusion
- References
Chapter 36: Gastric Plication for Obesity
- 36.1 Introduction
- 36.2 Indications and Contraindications
- 36.3 Technique
  - 36.3.1 Step 1: Operative Set-up
  - 36.3.2 Step 2: Access to the Abdomen
  - 36.3.3 Step 3: Placement of the Adjustable Gastric Band (AGB)
  - 36.3.4 Step 4: Gastroscopy
  - 36.3.5 Step 5: Identification of the Pylorus
  - 36.3.6 Step 6: Mobilization of the Greater Curvature
  - 36.3.7 Step 7: Alignment of the Greater Curvature Plication
  - 36.3.8 Step 8: Completion of the GCP
  - 36.3.9 Step 9: Final Gastroscopic Evaluation
  - 36.3.10 Step 10: AGB Port Placement
  - 36.3.11 Step11: Confirmation of Port Placement
- 36.4 Tips and Tricks
- 36.5 Recommendations from the Author
- References
Chapter 37: Malabsorptive and Mixed Procedures for Obesity
- 37.1 Introduction
  - 37.1.1 Limited Absorption and Mixed Procedures
  - 37.1.2 MGB
  - 37.1.3 BPD
  - 37.1.4 Learning from SIL
- References
Chapter 38: Revisional Obesity Surgery
- 38.1 Introduction
- 38.2 Operative Strategy and Technical Considerations
- 38.3 Technical and Physical Challenges in SLS Approach
  - 38.3.1 Lost Triangulation and Trocar Placement Strategy
  - 38.3.2 Conflict of Instruments
  - 38.3.3 Abdominal Wall Torque Effect
  - 38.3.4 Umbilical Recession
  - 38.3.5 Retraction of Large Liver
- 38.4 Operative Technique for RPL Revision of AGB to SG
  - 38.4.1 Transversus Abdominus Plan Block (TAP block)
- 38.5 Comment
- References
Chapter 39: Two or Combined Procedures
- 39.1 Introduction
  - 39.1.1 Indications
  - 39.1.2 Contraindications
- 39.2 Technique
  - 39.2.1 Instruments/Equipment
  - 39.2.2 Port Placement
- 39.3 Tips and Tricks (Compared to Multi Trocar Laparoscopy)
- 39.4 Recommendations from the Author
- References
Chapter 40: Urology
- 40.1 Introduction
- 40.2 Single-Port Retroperitoneal Laparoscopic Surgical Methods
- 40.3 Learning Curve
- 40.4 Comparative Outcomes Between Single-Port and Standard Retroperitoneal Laparoscopic Radical Nephrectomy
- 40.5 Discussion
- 40.6 Conclusions
- References
Chapter 41: Gynecology
- 41.1 Introduction
- 41.2 History of the Endoscope and Introduction of RPLS
  - 41.2.1 History of Laparoscopy
  - 41.2.2 Addition of Ports for Improving Manipulability and the Rationale of RPLS that Opposes Such Additions
- 41.3 Current Status of RPLS in the Field of Gynecologic Surgery
  - 41.3.1 Two-Port Laparoscopic Surgery
    - 41.3.1.1 Uterine Myomectomy (2-Port)
      - Securing a Good View Using a Flexible Scope
    - 41.3.1.2 Learning Curve in Acquiring the 2-Port Laparoscopic Technique
  - 41.3.2 Single-Port Laparoscopic Surgery (SPLS)
    - 41.3.2.1 SPLS for the Uterine Adnexae
    - 41.3.2.2 Linear Salpingostomy with the SILS Stitch (Covidien)
    - 41.3.2.3 Uterine Myomectomy (SPLS)
    - 41.3.2.4 Total Hysterectomy (SPLS)
    - 41.3.2.5 Promontory Fixation for Vaginal Prolapse After Total Hysterectomy (SPLS)
  - 41.3.3 Change in Thinking: Another Interpretation of RPLS
    - 41.3.3.1 Extra-Corporeal Ovarian Cystectomy (SPLS Through Only a Suprapubic Incision)
    - 41.3.3.2 Oophorectomy for Cryopreservation of Ovaries and Ovarian Transplantation by RPLS
- 41.4 Conclusion
- References
Chapter 42: Breast Surgery
- 42.1 Introduction to the Technique
- 42.2 Indications and Contraindications
- 42.3 Description of the Technique
  - 42.3.1 Three-Dimensional-Computed Tomography (3D-CT) Mammary Lymphography (LG)
  - 42.3.2 Endoscopic Sentinel Node Biopsy
- 42.4 VABS by TARM Approach
  - 42.4.1 Skin Incision
  - 42.4.2 Dissection Behind the Mammary Gland
  - 42.4.3 Dissection of the Subcutaneous Tissue Overlying the Tumor
  - 42.4.4 Partial Excision of the Gland Along With the Tumor and Safety Margin
  - 42.4.5 Breast Reconstruction
  - 42.4.6 Axillary Clearance
- 42.5 Tips and Tricks
- 42.6 Recommendations from the Author
- References
Chapter 43: Pediatric Surgery
- 43.1 Introduction
- 43.2 SLS in Children
- 43.3 Devices, Equipment and Instruments
- 43.4 Applications of SLS
- 43.5 Conclusions
- References