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FAQ

Are minimally invasive orthopedic surgical instruments suitable for use in pediatric patients?

Minimally invasive orthopedic surgical instruments are suitable for pediatric patients and have been widely used and proven in multiple fields. The following is a detailed analysis:

Less trauma and faster recovery: Multiple studies have shown that minimally invasive surgery has the advantages of less trauma and faster recovery. For example, laparoscopic minimally invasive surgery for external abdominal hernia in children has remarkable results and the children have mild stress reactions. Similarly, minimally invasive arthroscopic surgery has become the mainstream surgical method for children's joint diseases because of its small trauma and quick recovery.

Strong adaptability: Based on the characteristics of children's bones, such as good elasticity but low strength, prone to fractures, etc., minimally invasive surgery can better protect the epiphysis and avoid impact on the growth plate. In addition, the Pediatric Orthopedics Team of the Municipal Orthopedic Hospital emphasizes the principle of protecting the epiphysis when treating children's fractures. Treatment is performed through manual reduction and pressure between the epiphyses, which not only allows the epiphysis to heal quickly and avoids joint deformity, but also makes the incision very small.

Technology development: With the development of technology, small-diameter mirrors (such as 5 mm, 3 mm) suitable for children can be produced. These mirrors are gradually used in minimally invasive children's and adult surgeries on ventricles, joints, intervertebral discs, etc. In addition, robotic surgical systems such as the da Vinci robotic surgical system have also shown high accuracy and safety in children and some adult patients with congenital malformations.

Clinical application: Multiple studies and reports have shown that minimally invasive surgery has achieved good clinical results in children's orthopedics, thoracic surgery and other fields. For example, in pediatric orthopedic medical services, the Department of Pediatric Orthopedics of the Municipal Orthopedic Hospital adopts international advanced technology, which greatly enhances the efficacy and reduces the probability of sequelae. In addition, minimally invasive thoracoscopic surgery has also shown superiority in general thoracic surgical diseases in children.

Case study: Specific cases show that minimally invasive surgery is very effective for pediatric patients. For example, a 3-year-old child underwent closed reduction and Kirschner wire internal fixation for a supracondylar humeral fracture without incision and recovered well after the operation. Another example is skull base surgery using the PIEZOSURGERY® device, which uses ultrasonic micro-vibration technology to achieve precise cutting and minimally invasive treatment, minimizing damage to surrounding soft tissues.

In summary, minimally invasive orthopedic surgical instruments are not only suitable for pediatric patients, but have also proven their superiority and safety in multiple fields. Therefore, choosing minimally invasive surgery is a wise and effective choice for pediatric patients requiring orthopedic surgery.

What studies have been conducted on the safety of minimally invasive orthopedic surgical devices in pediatric patients?

Regarding the research on the safety of minimally invasive orthopedic surgical instruments in pediatric patients, detailed analysis can be conducted from the following aspects:

Effectiveness and safety of minimally invasive surgical methods:

Regarding the minimally invasive surgical treatment of urinary tract stones in children, a study retrospectively analyzed the clinical data of 9 children with urinary tract stones treated between January 2019 and August 2022, confirming the effectiveness and effectiveness of minimally invasive surgical methods. Security.
Perioperative management and adverse event control:

Studies on the use of nicardipine in perioperative blood loss in orthopedics have shown that controlled blood pressure lowering can reduce the incidence of postoperative adverse events, including complications such as surgical failure and infection. This suggests that appropriate medication use in perioperative management can improve surgical safety.
Application of robotic technology in image-guided surgery:

Research shows that in image-guided surgery of cranial implants, robotics-based systems can effectively assess surgical safety and effectiveness. Although there are certain risks (such as part of the prosthesis touching or penetrating the ventricle), the selection of the optimal implantation location can significantly improve safety.
Advantages of overall minimally invasive surgery:

Minimally invasive surgery has the advantages of less trauma, less bleeding, faster recovery, shorter hospital stay and reduced economic costs. These characteristics make it the first choice for more and more patients. However, even simple surgeries need to be performed by specialists in regular medical institutions to ensure safety.
Safety studies in specific surgical areas:

For minimally invasive tumor surgery, more research is needed to further stratify to ensure its safety. In addition, high cost is also a problem affecting the treatment of children in economically underdeveloped areas.
Safety and effectiveness in neurosurgery:

Studies of the use of topical medications to prevent postoperative infections in neurosurgery have shown that this approach not only improves surgical safety but is also potentially cost-effective.

What are the long-term complication rates after minimally invasive surgery in children?

There are certain differences in the long-term complication rates after minimally invasive surgery in children, which may be related to the type of surgery, patient age, number of surgeries and other factors. Here is the evidence extracted:

In a retrospective study by Sun Baochun et al. based on 2089 cases, the total incidence of complications on the second to fifth days after low-temperature plasma-assisted children's adenoid and tonsil surgery was 1.63%, of which bleeding was 0.24% and recurrence was 0.14%. , prevertebral lymphadenitis 0.96%.

In a follow-up study conducted by Shen Mengya et al. based on Beijing Tongren Hospital Affiliated to Capital Medical University, the incidence rate of postoperative complications in children with juvenile recurrent respiratory papilloma (JORRP) was 44.12%.

Craniopharyngioma is one of the most common intracranial congenital tumors in children. It has severe postoperative reactions, many complications, high recurrence rate, and poor quality of life. It is called a "biologically malignant" benign tumor.

In a study on Wanfang Medical Online, the complications and postoperative outcomes of tracheostomy in children due to different causes were discussed, but the specific incidence rate was not provided.

Long-term complication rates after minimally invasive surgery in children vary significantly across studies, ranging from 1.63% to 44.12%.

How to evaluate the impact of minimally invasive orthopedic surgical instruments on children's growth and development?

Evaluating the impact of minimally invasive orthopedic surgical instruments on children's growth and development requires comprehensive consideration of multiple factors, including the type of surgery, the method of surgery, and the child's individual differences and specific disease conditions. The following is a detailed analysis:

Children's bones are significantly different from those of adults, especially during the growth and development stages, and the bone structure and function at each stage have different characteristics. Therefore, when choosing a treatment, special care must be taken to avoid affecting the child's growth plates, which may lead to skeletal deformities.

For benign bone tumors, minimally invasive surgery will not cause adverse effects on children's growth and development in most cases. However, for malignant bone tumors, radical surgical resection is usually required, which may have a certain impact on the growth and development of children.

Minimally invasive surgery has been widely used in pediatric surgery and has achieved good therapeutic effects. Its main advantage is that it can minimize damage to normal tissues and functions of children, thereby reducing negative effects on growth and development.

The nutritional status of children is very sensitive to their growth rate, so strict nutritional management and growth monitoring should be carried out before and after surgery. It is recommended to use growth curves such as the FENTON curve to longitudinally and continuously evaluate the growth and development of children.

Modern imaging techniques such as diffusion tensor imaging (DTI) can quantitatively reflect the microstructure and morphological changes of the epiphysis and metaphysis, providing strong support for the assessment of growth and development disorders in children. These technologies can help doctors more accurately determine the specific impact of surgery on children's growth and development.

Although minimally invasive surgery has achieved certain results in the field of children's orthopedics, there are still some problems in the actual operation process, such as "emphasis on appearance over function" and neglect of overall functional recovery of the whole body. Therefore, existing clinical concepts and evaluation standards need to be further improved to ensure that surgery not only focuses on local effects, but also comprehensively considers the impact on children's overall health.

In summary, evaluating the impact of minimally invasive orthopedic surgical instruments on children's growth and development requires a multi-faceted approach, including consideration of the type of surgery, individual differences, nutritional management, imaging monitoring, and continuous reflection and improvement in clinical practice.

What are the latest advances in minimally invasive orthopedic surgical instruments for treating fractures in children?

The latest progress of minimally invasive orthopedic surgical instruments in the treatment of children's fractures is mainly reflected in the following aspects:

Elastic intramedullary nailing (ESIN) technology: This technology is accepted by most pediatric orthopedic surgeons because of its minimally invasive, no damage to the epiphysis, easy operation, quick postoperative recovery, early functional exercise, and low complication rate. And it has developed into a mainstream technology for treating long bone fractures of children's limbs. Despite this, there are still some complications after ESIN, such as tendon and iatrogenic nerve injury.

Percutaneous needle combined with external fixator: This method is mainly used for the treatment of proximal humerus fractures in older children. Percutaneous Kirschner wire internal fixation combined with plaster external fixation maintenance and external fixator maintenance can effectively treat Neer type II and III fractures.

Ultrasound-guided minimally invasive treatment: Chief physician Shen Xiantao of Wuhan Children's Hospital led a team to create the first "ultrasound-guided minimally invasive treatment of traumatic fractures in children" program, changing the traditional fracture diagnosis and treatment model. This new technology does not require X-ray positioning, reducing radiation exposure to patients.

Minimally invasive fixation treatment of distal tibial fractures: Minimally invasive percutaneous treatment of distal tibial fractures can reduce damage to soft tissue and facilitate early healing.

Knee arthroscopic anterior cruciate ligament reconstruction: This surgery is completed through 5 incisions with a diameter of no more than 5mm. It can effectively restore the stability of the knee joint and avoid hindering the child's future healthy activities and sports career.

What are the advantages of robotic technology used in minimally invasive surgery in children over traditional surgery?

Robotic technology used in minimally invasive surgery for children has many advantages over traditional surgery:

Surgical field of view magnification and tremor filtering: Robot-assisted surgery greatly improves the accuracy and safety of surgery through three-dimensional magnification and tremor filtering technology.

Precise and flexible operation: The robotic surgical system is capable of high-precision and flexible operation, especially in narrow anatomical spaces, enabling fine control.

Small incisions and quick recovery: Compared with traditional large-incision surgery, robot-assisted minimally invasive surgery usually requires only a few small incisions, which not only reduces trauma, but also speeds up postoperative recovery and reduces the probability of postoperative complications. .

Multifunctional integration and easy operation: Some minimally invasive surgical robots are designed to be miniaturized, easy to operate, and shape-controllable, and are suitable for various complex surgical environments.

Gravity compensation and reverse transmission capabilities: Advanced robot design includes gravity compensation and reverse transmission capabilities. These features help improve the stability and safety of surgery.

Innovative instrument design: For example, Weigao's "Miaoshou" robot adopts multi-degree-of-freedom wire transmission decoupling design technology to improve the flexibility of instrument movement and tissue processing capabilities.

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