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By A. Smamsa

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The experience of the surgeon may also be a contributory factor. , 2009a). 9% among trainee paediatric surgeons. A list of possible complications is presented in Table 4. Rigorus pursuit of haemostasis is essential for success in laparoscopic surgery as blood in the operating field significantly reduces visibility. Adequate control of blood vessels of target organ must be achieved to minimise risk of uncontrollable blood loss this often being the reason for conversion to an open approach. Vascular injury can affect the primary target organ or secondary intra-abdominal organs.

The position of the patient depends on the target organ for the procedure. Supine position can be applied to a good number of the procedures. A Trendelenburg position may be preferred for pelvic laparoscopy and a reverse Trendelenburg position for upper abdominal laparoscopy to visualise the diaphragm and its Laparoscopy in Children and Infants 35 Fig. 1. Operative positioning for laparoscopic appendicectomy. S: surgeon, As: surgeon’s assistant, N: scrub nurse, An: anaesthetist, Tp: table with patient.

2009). Development of atelectasis and arterial to end-tidal PCO2- difference in a porcine model of pneumoperitoneum. 2, (Aug 2009), pp. 298–303, ISSN 0007-0912 Takahata, O; Kunisawa, T; Nagashima, M; Mamiya, K; Sakurai, K; Fujita, S; Fujimoto, K. & Iwasaki, H. (2007). Effect of age on pulmonary gas exchange during laparoscopy in the Trendelenburg lithotomy position. 6, (Jul 2007), pp. 687-92, ISSN 0001-5172 Talab, HF; Zabani, IA; Abdelrahman, HS; Bukhari, WL; Mamoun, I; Ashour, MA; Sadeq, BB. & El Sayed, SI.

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