The article was consulted professionally by ThS.BS Vu Van Quan – General Department of General Medicine – Anesthesia, Share99 Hai Phong International Health Hub. The doctor has more than 10 years of experience working in General Digestive Foreign Affairs.
Hypertrophic stenosis is a common pathology between newborn age and breastfeeding. The treatment is mainly scientific. In which, laparoscopic surgery to treat stenosis has many advantages to bring efficiency to patients.
1. What is hypertrophic stenosis?
- Hypertrophic stenosis has an anotomical lesion on the body in the form of an oval fibrous muscle tumor, about 2cm in diameter, 3-4cm long. Internal analysis showed that the corneal layer is normal, the muscle layer is mainly the hypertrophic sysic sysic opening.
- The disease is clinically manifested by vomiting syndrome caused by a narrowing of the anesthetic by excessive hypertrosenterosis of the amen muscle layer.
- A narrowing of a positional hypertroscture if diagnosed late and treated incorrectly will lead to dehydration, rapid weight loss, severe depletion and difficulty recovering. The progress of laparoscopic surgery and resuscitation anesthesia in recent times has brought very positive results for pediatric patients.
- The cause of the narrowing of the position so far is not really clear.
- Hypertrophic stenosis is the main cause of gastric obstruction most commonly seen in babies and infants.
- The diagnosis of permanosis is mainly based on characteristics on abdominal ultrasound.
2. Clinical symptoms
Post-birth babies have a completely normal period usually about 2-4 weeks after birth, after which clinical symptoms appear.
- Vomiting: This is a very specific and clinically suggested sign by the following characteristics:
- Starting with the phenomenon of irony and then gradually vomiting violently.
- The number of vomiting increases gradually, at first vomiting only a few times a day, later every feeding is one vomiting.
- Vomiting occurs slowly after feeding.
- Vomiting out the entire white (suck-in milk), there is never the presence of bile (yellow or blue) bile.
- After vomiting the child becomes hungry and demands to feed immediately.
- Constipation: The amount of feces is small and has a blue color as a form of stool.
- Little urination.
Symptoms of the whole body include:
Patients presenting with severe dehydration, weight loss compared to birth, sunken eyes, slow skin pinching, water eagerness
- Soft, flattened belly, recessed boat
- A small, rounded lump on the navel can be palpable. This is a very important sign for clinical diagnosis.
3. Laparoscopic surgery for hypertrophic stenosis
Prescribed medical treatment in all cases is diagnosed with hypertrophic stenosis.
- Contraint prescribed to children: Hemolysis disorders, electrolysis, contraint prescribed other laparoscopic surgery.
- Technical person: Experienced digestive surgeon in laparoscopic surgery, anesthesisithesisithesithesiscope and experienced instrument.
- The patient is placed on his back at the end of the operating table, the surgeon stands on the paediatric leg, the endoscopic screen is located opposite.
- The patient is anesthetizing, sucking out gastric juice.
- Use a regular knife or electric knife to incision along the navel about 5mm into the peritoneal cavity.
- Pump CO2 into the abdomen with low pressure from 6-8 cmH2O.
- Make two small incisions in the upper right and left abdomens.
- Place the endoscopic instrument in the upper incision. Use the grasper to hold the duodenum adjacent to the position and use a knife to cut along the position. In the event that there is no amenectar cutter, a 3mm monoposity burner can be used to cut the body, using a small burning level.
- Use endoscopic muscle balls to completely separate the amen muscle tumor until the mucous membranes swell.
- Large conjunctivitis can be applied to the muscle opening to prevent bleeding.
- Inflatable through the stomach to check for perforation.
- Remove the tool from the abdomen.
- Close the umbilical cord scales and stitch the skin
- Incision infection.
- Incision hernia: close the incision.
- Recurrence due to non-complete muscle dissection, after surgery the child may still have symptoms such as vomiting.
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