Pediatric Colorectal And Pelvic Surgery

This book provides comprehensive coverage of the anatomical and physiological aspects of complex colorectal and pelvic malformations. Also described are the surgical protocols for this specialized field within pediatric surgery. The benefits of high-level collaboration between surgical services when treating these anomalies are explained, as are treatment algorithms and care of complications. Includes evaluation and management of the newborn Describes surgical interventions of the newborn, and when a primary repair versus a staged approach is required Explains the value of laparoscopy and deciding in which cases to use it Looks at the importance of a transition program to adulthood Pediatric surgeons worldwide and the teams in which they work will benefit from this well illustrated and comprehensive work.

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.

This new handbook teaches and explains the key principles in the management of complex pediatric colorectal diagnoses. By using case-based presentations, radiographic images, operative images with Multiple Choice Questions to test knowledge, this book serves as an invaluable educational tool. ‘Learning Points’ are included and the text includes comprehensive explanatory chapters. The 60 cases included encompass the full range of pediatric conditions, and the additional learning material completes this unique handbook. The e-book further enhances the learning experience for all clinicians involved in the treatment of children suffering from colorectal disorders.

Within the field of pediatric colorectal and pelvic reconstruction, the most complex anatomic problem a pediatric surgeon can face is that of a cloacal malformation. The urinary tract, gynecologic system, and distal bowel all fuse into a single common channel which must be surgically reconstructed. The care of patients with a cloaca is daunting, and the spectrum of anatomic variations very wide. In this book about cloaca, the authors have brought organization to the complex, providing basic principles of care, from fetal and newborn management to the reconstruction of bowel, gynecologic systems, and urinary tracts as well as the care of patients after surgery to puberty and beyond. This is a comprehensive account of all elements of care for the cloaca patient. It includes preoperative evaluation and surgical planning, the anorectal malformation (ARM) index, surgical reconstruction, urological evaluation and long-term care. Also covered are the gynecologic evaluation and intervention, neurological implications, bowel management and the long-term management of patients with cloacal malformations. Case studies provide valuable insights into a wide range of clinical scenarios, never previously categorized so comprehensively. These studies enable the reader to understand and gain experience from detailed descriptions. Fully illustrated, in color, and with further resources available online, this is a unique resource for all clinicians within the pediatric team caring for patients with cloacal malformations. In addition, specialists across numerous fields, including colorectal surgery, urology, gynecology, and gastrointestinal motility, as well as neonatology, orthopedics, neurosurgery, anesthesia, radiology, psychology, social work, nutrition, and nursing, will find this practical clinical text and its online resources to be an invaluable when dealing with the complex needs of the cloaca patient.

This superbly illustrated book on the surgical treatment of pediatric colorectal problems focuses in particular on the specific technical maneuvers that may be considered key to successful results. The presented management concepts are based on a database comprising over 5000 patients, more than 2300 of whom have been operated on by one of the authors as lead surgeon over the past 30 years. The full range of colorectal disorders in children is thus covered, from cloaca and fistulas to rare presentations. In addition, chapters are included on topics such as prenatal diagnosis, minimally invasive techniques, recent advances in imaging, and a bowel management program for fecal incontinence. Surgical Treatment of Colorectal Problems in Children is eminently a practical book. Clarity, simplicity and applicability are emphasized throughout. The excellence of the illustrations and photographs is a crucial feature and the reader will also have access to instructive videos of procedures.

This book focuses on the management of children with fecal incontinence and constipation. Despite accurate anatomic reconstruction, many children still suffer from a variety of functional bowel problems. These include not only children with congenital anatomic problems such as anorectal malformations and Hirschsprung disease, but also includes the huge population of children who suffer from constipation, with or without soiling, and a large spinal population (spina bifida) who have bowel problems.

This third edition text provides a completely revised and updated new version of this unique, modern, practical text that covers the strategic evaluation, specific approaches, and detailed management techniques utilized by expert colorectal surgeons caring for patients with complex problems–whether they result from underlying colorectal disease or from complications arising from previous surgical therapy. The format follows that of both a “how to” manual as well as an algorithm-based guide to allow the reader to understand the thought process behind the proposed treatment strategy. By making use of evidence-based recommendations, each chapter includes not only background information and diagnostic/therapeutic guidelines, but also provides a narrative by the author on his/her operative technical details and perioperative “tips and tricks” that they utilize in the management of these complex surgical challenges. Distinctive to this book, is the reliance on experts in the field including past presidents of the ASCRS, as well as multiple other national and internationally recognized surgeons, to lend their personal insight into situations where data may be more sparse, but individual and collective experience is paramount to making sound decisions and thereby optimizing patient outcomes. The text includes chapters on the assessment of risk and methods utilized to minimize perioperative complications. In addition, it incorporates sections covering the medical and surgical therapies for abdominal, pelvic and anorectal disease. Moreover, the technical challenges of managing complications resulting from the original or subsequent operations is addressed. The underlying focus throughout the text is on providing pragmatic and understandable solutions that can be readily implemented by surgeons of varying experience to successfully treat complex colorectal problems. However, it also goes beyond the technical aspects of colorectal surgery and includes special sections highlighting the essence of a surgeon; covering aspects involving the medical-legal, ethical, and economic challenges confronting surgeons. Throughout the text, each author provides an ongoing narrative of his/her individual surgical techniques along with illustrations and diagrams to “personally” take the reader through the crucial steps of the procedure, and key points of patient care inherent to that topic. Additionally, where appropriate, links to online videos give the reader an up-front look into technical aspects of colorectal surgery.

Written by emerging young leaders in the field, Pelvic Floor Disorders for the Colorectal Surgeon provides a current, thought-provoking, and practical study of the approach to and treatment of pelvic floor disorders.