Echo-Endoscopy Combined with Virtual Reality: A Whole Perspective of Laparoscopic Common Bile Duct Exploration in Children
<i>Introduction:</i> Endoscopic procedures are performed more frequently in children due to technological advances that can be safely performed in an adequate setting with a support of a multidisciplinary team. Pediatric indications for ERCP (endoscopic retrograde cholangiopancreatograph...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-04-01
|
| Series: | Children |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9067/10/4/760 |
| _version_ | 1797605965105725440 |
|---|---|
| author | Francesca Destro Raffaele Salerno Valeria Calcaterra Sandro Ardizzone Milena Meroni Margherita Roveri Ugo Maria Pierucci Alberta Zaja Francesco Rizzetto Alessandro Campari Maurizio Vertemati Paolo Milani Gloria Pelizzo |
| author_facet | Francesca Destro Raffaele Salerno Valeria Calcaterra Sandro Ardizzone Milena Meroni Margherita Roveri Ugo Maria Pierucci Alberta Zaja Francesco Rizzetto Alessandro Campari Maurizio Vertemati Paolo Milani Gloria Pelizzo |
| author_sort | Francesca Destro |
| collection | DOAJ |
| description | <i>Introduction:</i> Endoscopic procedures are performed more frequently in children due to technological advances that can be safely performed in an adequate setting with a support of a multidisciplinary team. Pediatric indications for ERCP (endoscopic retrograde cholangiopancreatography) and EUS (endoscopic ultrasound) occur mainly due to congenital malformations. In a pediatric case series, we report the application of EUS combined with duodenoscopy, eventually associated with ERCP and minimally invasive surgery, highlighting the importance of defining a tailored dedicated management pathway for each patient. <i>Patients and methods:</i> A series of 12 patients, managed at our Center in the last three years, were evaluated, and their management was discussed. <i>Results:</i> EUS was performed in eight patients and permitted the differential diagnosis of duplication cysts and the visualization of the biliary tree and pancreatic anatomy. ERCP was attempted in five patients: in one case, it permitted the preservation of pancreatic tissue, postponing surgery and in three patients, it was technically unfeasible. MIS (minimally invasive surgery) was performed in seven patients, two with laparoscopic common bile duct exploration (LCBDE). Precise anatomical definition and the possibility of surgical simulation and team sharing were evaluated under VR HMD (Virtual Reality Head Mounted Display) in four cases. <i>Conclusions:</i> Exploration of the common bile duct in children differs from that of the adult population and combines echo-endoscopy and ERCP. The integrated use of minimally invasive surgery in the pediatric area is necessary for the whole management perspective in complex malformations and small patients. The introduction in the clinical practice of a preoperative study with Virtual Reality allows a better survey of the malformation and a tailored treatment. |
| first_indexed | 2024-03-11T05:08:36Z |
| format | Article |
| id | doaj.art-eeb5e77e134348eca837b7b476d6dbfa |
| institution | Directory Open Access Journal |
| issn | 2227-9067 |
| language | English |
| last_indexed | 2024-03-11T05:08:36Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Children |
| spelling | doaj.art-eeb5e77e134348eca837b7b476d6dbfa2023-11-17T18:47:18ZengMDPI AGChildren2227-90672023-04-0110476010.3390/children10040760Echo-Endoscopy Combined with Virtual Reality: A Whole Perspective of Laparoscopic Common Bile Duct Exploration in ChildrenFrancesca Destro0Raffaele Salerno1Valeria Calcaterra2Sandro Ardizzone3Milena Meroni4Margherita Roveri5Ugo Maria Pierucci6Alberta Zaja7Francesco Rizzetto8Alessandro Campari9Maurizio Vertemati10Paolo Milani11Gloria Pelizzo12Department of Pediatric Surgery, “Vittore Buzzi” Children’s Hospital, 20154 Milan, ItalyGastrointestinal and Digestive Endoscopy Unit, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Pediatrics, “Vittore Buzzi” Children’s Hospital, 20154 Milan, ItalyGastrointestinal and Digestive Endoscopy Unit, ASST Fatebenefratelli Sacco, 20157 Milan, ItalyDepartment of Pediatric Surgery, “Vittore Buzzi” Children’s Hospital, 20154 Milan, ItalyDepartment of Pediatric Surgery, “Vittore Buzzi” Children’s Hospital, 20154 Milan, ItalyDepartment of Pediatric Surgery, “Vittore Buzzi” Children’s Hospital, 20154 Milan, ItalyCIMaINa (Interdisciplinary Centre for Nanostructured Materials and Interfaces), University of Milano, 20133 Milan, ItalyPostgraduate School of Diagnostic and Interventional Radiology, University of Milan, via Festa del Perdono 7, 20122 Milan, ItalyDepartment of Pediatric Radiology, “Vittore Buzzi” Children’s Hospital, 20154 Milan, ItalyCIMaINa (Interdisciplinary Centre for Nanostructured Materials and Interfaces), University of Milano, 20133 Milan, ItalyCIMaINa (Interdisciplinary Centre for Nanostructured Materials and Interfaces), University of Milano, 20133 Milan, ItalyDepartment of Biomedical and Clinical Science, University of Milano, 20157 Milan, Italy<i>Introduction:</i> Endoscopic procedures are performed more frequently in children due to technological advances that can be safely performed in an adequate setting with a support of a multidisciplinary team. Pediatric indications for ERCP (endoscopic retrograde cholangiopancreatography) and EUS (endoscopic ultrasound) occur mainly due to congenital malformations. In a pediatric case series, we report the application of EUS combined with duodenoscopy, eventually associated with ERCP and minimally invasive surgery, highlighting the importance of defining a tailored dedicated management pathway for each patient. <i>Patients and methods:</i> A series of 12 patients, managed at our Center in the last three years, were evaluated, and their management was discussed. <i>Results:</i> EUS was performed in eight patients and permitted the differential diagnosis of duplication cysts and the visualization of the biliary tree and pancreatic anatomy. ERCP was attempted in five patients: in one case, it permitted the preservation of pancreatic tissue, postponing surgery and in three patients, it was technically unfeasible. MIS (minimally invasive surgery) was performed in seven patients, two with laparoscopic common bile duct exploration (LCBDE). Precise anatomical definition and the possibility of surgical simulation and team sharing were evaluated under VR HMD (Virtual Reality Head Mounted Display) in four cases. <i>Conclusions:</i> Exploration of the common bile duct in children differs from that of the adult population and combines echo-endoscopy and ERCP. The integrated use of minimally invasive surgery in the pediatric area is necessary for the whole management perspective in complex malformations and small patients. The introduction in the clinical practice of a preoperative study with Virtual Reality allows a better survey of the malformation and a tailored treatment.https://www.mdpi.com/2227-9067/10/4/760ERCPendoscopic USlaparoscopy (LCBDE)virtual realitychildren |
| spellingShingle | Francesca Destro Raffaele Salerno Valeria Calcaterra Sandro Ardizzone Milena Meroni Margherita Roveri Ugo Maria Pierucci Alberta Zaja Francesco Rizzetto Alessandro Campari Maurizio Vertemati Paolo Milani Gloria Pelizzo Echo-Endoscopy Combined with Virtual Reality: A Whole Perspective of Laparoscopic Common Bile Duct Exploration in Children Children ERCP endoscopic US laparoscopy (LCBDE) virtual reality children |
| title | Echo-Endoscopy Combined with Virtual Reality: A Whole Perspective of Laparoscopic Common Bile Duct Exploration in Children |
| title_full | Echo-Endoscopy Combined with Virtual Reality: A Whole Perspective of Laparoscopic Common Bile Duct Exploration in Children |
| title_fullStr | Echo-Endoscopy Combined with Virtual Reality: A Whole Perspective of Laparoscopic Common Bile Duct Exploration in Children |
| title_full_unstemmed | Echo-Endoscopy Combined with Virtual Reality: A Whole Perspective of Laparoscopic Common Bile Duct Exploration in Children |
| title_short | Echo-Endoscopy Combined with Virtual Reality: A Whole Perspective of Laparoscopic Common Bile Duct Exploration in Children |
| title_sort | echo endoscopy combined with virtual reality a whole perspective of laparoscopic common bile duct exploration in children |
| topic | ERCP endoscopic US laparoscopy (LCBDE) virtual reality children |
| url | https://www.mdpi.com/2227-9067/10/4/760 |
| work_keys_str_mv | AT francescadestro echoendoscopycombinedwithvirtualrealityawholeperspectiveoflaparoscopiccommonbileductexplorationinchildren AT raffaelesalerno echoendoscopycombinedwithvirtualrealityawholeperspectiveoflaparoscopiccommonbileductexplorationinchildren AT valeriacalcaterra echoendoscopycombinedwithvirtualrealityawholeperspectiveoflaparoscopiccommonbileductexplorationinchildren AT sandroardizzone echoendoscopycombinedwithvirtualrealityawholeperspectiveoflaparoscopiccommonbileductexplorationinchildren AT milenameroni echoendoscopycombinedwithvirtualrealityawholeperspectiveoflaparoscopiccommonbileductexplorationinchildren AT margheritaroveri echoendoscopycombinedwithvirtualrealityawholeperspectiveoflaparoscopiccommonbileductexplorationinchildren AT ugomariapierucci echoendoscopycombinedwithvirtualrealityawholeperspectiveoflaparoscopiccommonbileductexplorationinchildren AT albertazaja echoendoscopycombinedwithvirtualrealityawholeperspectiveoflaparoscopiccommonbileductexplorationinchildren AT francescorizzetto echoendoscopycombinedwithvirtualrealityawholeperspectiveoflaparoscopiccommonbileductexplorationinchildren AT alessandrocampari echoendoscopycombinedwithvirtualrealityawholeperspectiveoflaparoscopiccommonbileductexplorationinchildren AT mauriziovertemati echoendoscopycombinedwithvirtualrealityawholeperspectiveoflaparoscopiccommonbileductexplorationinchildren AT paolomilani echoendoscopycombinedwithvirtualrealityawholeperspectiveoflaparoscopiccommonbileductexplorationinchildren AT gloriapelizzo echoendoscopycombinedwithvirtualrealityawholeperspectiveoflaparoscopiccommonbileductexplorationinchildren |