TEF 2015

Part of Esophageal Atresia and Tracheoesophageal Fistula 20 items

Document · May 2026 · 1 min read

In brief

Technical presentation on thoracoscopic repair of esophageal atresia with tracheoesophageal fistula, covering patient positioning, insufflation parameters, and anastomotic technique. Includes data on cerebral oxygenation effects during CO₂ insufflation and comparative outcomes between thoracoscopic and open approaches.

CO₂ insufflation at 5 mmHg during thoracoscopic TEF repair causes arterial desaturation (96→93%) and hypercarbia but cerebral oxygenation remains stable
Modified lateral decubitus positioning (more prone than not) with 30° scope optimizes visualization for thoracoscopic esophageal atresia repair
Thoracoscopic approach for EA/TEF is feasible in neonates as small as 2.4 kg with isolated anomalies using low-pressure insufflation (4-5 mmHg)
Anastomosis technique: back row intraluminal, front row extraluminal using 5-0 PDS/Vicryl interrupted sutures for primary TEF repair
Thoracoscopic repair demonstrates superior midterm musculoskeletal outcomes and cosmesis compared to thoracotomy in pediatric TEF patients

Written by the GCMD Library team from the document.

Dr. Steve Rothenberg

Surgical content by Dr. Steve Rothenberg — Thoracic Surgery

Full text

BERLIN

. Ped Endosurg Innovative Tech. (3); 141-148, 1999.

3.2 kg male, isolated anomaly/IPEG AtlantaPed Endosurg Innov Tech. (4) 289-294. 2000

J Pediatr Surg (37) 869-872; 2002

Not required!

Modified Lat Decubitus Head Monitor MonitorSurgeonAssist Nurse

(often it is necessary to go to pressure of 10 but then you can decrease to 4-5 )

Place more prone then not!30 degree scope, more posterior looks down on instruments.

Left hand moreposterior

(clip) 5-0 PDS or Vicryl Back row intra-luminal,Front row extra-luminal (single interrupted)

RMHC and CHOP : IPEG 2015

Bishay M1, Giacomello L, Retrosi G, Thyoka M, Garriboli M, Brierley J, Harding L, Scuplak S, Cross KM, Curry JI, Kiely EM, De Coppi P , Eaton S, Pierro A.

The effect of CO₂-insufflation with 5 mmHg on the cerebral oxygenation in thoracoscopic repair of oesophageal atresia in neonates, L.J. Stolwijk, S.H.A.J. Tytgat, K. Keunen, M.J.N.L. Benders, J.C. de Graaff, D.C. van der Zee, P .M.A. Lemmers, M.Y .A. van Herwaarden, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands 14 neonates GA 36.9 [30.6-41.9] BW 2358 [1395–4490] Arterial saturation (%) (%) * (mmHg) Arterial CO2 * (mmHg) Mean arterial blood pressure

The effect of CO₂-insufflation with 5 mmHg on the cerebral oxygenation in thoracoscopic repair of oesophageal atresia in neonates, L.J. Stolwijk, S.H.A.J. Tytgat, K. Keunen, M.J.N.L. Benders, J.C. de Graaff, D.C. van der Zee, P .M.A. Lemmers, M.Y .A. van Herwaarden, Wilhelmina Children's Hospital, University Medical Center Utrecht, the Netherlands rScO₂ (%) Cerebral oxygenation 5 mmHg SaO₂ ↓ 96.3% to 92.5% paCO₂ ↑ 47±6.9 to 58±13 mmHg MABP remained stable rScO₂ remained stable

Annals Thoracic Surgery 2009Thoracoscopy Versus Thoracotomy ImprovesMidterm Musculoskeletal Status and Cosmesis inInfants and ChildrenTaiwo A. Lawal, MBBS, Jan-H. Gosemann, Joachim F. Kuebler, MD,Sylvia Glüer, MD, PhD, and Benno M. Ure, MD, PhDDepartment of Pediatric Surgery, Hannover Medical School, Hannover, Germany

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