Modified iris system: initial experience with a new technology for safety in hiatal surgery in pediatric patients
Purpose: We present our initial experience with a modified IRIS U-kit system (MIUS) (Stryker, USA) for real-time esophageal visualization during Nissen fundoplication (NF) surgery in pediatric patients, aiming to enhance safety and reduce complications, especially in cases involving esophageal dysmo...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-04-01
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| Series: | Journal of Pediatric Surgery Open |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2949711625000103 |
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| author | Joel Cazares Eduardo De la Rosa-Bustamante Jorge Colín-Garnica Arturo Guillen-Cárdenas Marbella Sepulveda-Valenzuela Miguel Torres-Salas Jorge Alberto Cantú-Reyes |
| author_facet | Joel Cazares Eduardo De la Rosa-Bustamante Jorge Colín-Garnica Arturo Guillen-Cárdenas Marbella Sepulveda-Valenzuela Miguel Torres-Salas Jorge Alberto Cantú-Reyes |
| author_sort | Joel Cazares |
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| description | Purpose: We present our initial experience with a modified IRIS U-kit system (MIUS) (Stryker, USA) for real-time esophageal visualization during Nissen fundoplication (NF) surgery in pediatric patients, aiming to enhance safety and reduce complications, especially in cases involving esophageal dysmotility and neurological impairments. Methods: A retrospective, experimental study from April to June 2023 including patients with Gastroesophageal Reflux Disease (GERD). The IRIS U-kit, originally designed for urology, was adapted to aid esophageal visualization. This system utilized an illuminated ureteral stent with optical fibers inserted into a feeding tube (bougie). Results: Five pediatric patients with an average age of 6.2 years successfully underwent laparoscopic NF. Three patients had neurological impairments, one had trisomy 21, and one had no neurological issues. Using MIUS enabled real-time esophageal visualization throughout the surgery, even in challenging areas affected by periesophagitis. No complications were reported. All NF procedures, with or without additional interventions like gastrostomy and pyloroplasty, were completed safely. Discussion: NF surgery in pediatric patients, especially those with neurological impairments, poses risks of complications including perforations. Real-time esophageal visualization using the MIUS proved valuable in enhancing surgical safety, preventing complications and as an educational tool for resident training. Conclusions: The MIUS demonstrated feasibility and safety in NF surgery for pediatric patients, even in cases with esophageal dysmotility and neurological impairments without using endoscopy. This innovative approach has the potential to be applied in reoperations, Heller myotomies, and esophageal atresias. To our knowledge, this is the first successful use of the IRIS system in non-urological patients. |
| format | Article |
| id | doaj-art-e18310675b0c4072a130aebc021902c5 |
| institution | Kabale University |
| issn | 2949-7116 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pediatric Surgery Open |
| spelling | doaj-art-e18310675b0c4072a130aebc021902c52025-02-09T05:01:48ZengElsevierJournal of Pediatric Surgery Open2949-71162025-04-0110100201Modified iris system: initial experience with a new technology for safety in hiatal surgery in pediatric patientsJoel Cazares0Eduardo De la Rosa-Bustamante1Jorge Colín-Garnica2Arturo Guillen-Cárdenas3Marbella Sepulveda-Valenzuela4Miguel Torres-Salas5Jorge Alberto Cantú-Reyes6Department of Pediatric Surgery, Hospital Regional de Alta Especialidad Materno Infantil, Monterrey, Mexico; Correspondence author at: Pediatric Surgery, Hospital Regional de Alta Especialidad Materno Infantil, Monterrey, Mexico, Avenida San Rafael No. 450. Colonia San Rafael Guadalupe, Nuevo Leon CP 67140, Mexico.Pediatric Surgery Residency Program Universidad de Monterrey (UDEM), Hospital Regional Materno Infantil de Alta Especialidad de Nuevo Leon, Monterrey, MexicoPediatric Surgery Residency Program Universidad de Monterrey (UDEM), Hospital Regional Materno Infantil de Alta Especialidad de Nuevo Leon, Monterrey, MexicoPediatric Surgery Residency Program Universidad de Monterrey (UDEM), Hospital Regional Materno Infantil de Alta Especialidad de Nuevo Leon, Monterrey, MexicoDepartment of Pediatric Surgery, Hospital Regional de Alta Especialidad Materno Infantil, Monterrey, MexicoDepartment of Pediatric Surgery, Hospital Regional de Alta Especialidad Materno Infantil, Monterrey, MexicoDepartment of Pediatric Surgery, Hospital Regional de Alta Especialidad Materno Infantil, Monterrey, MexicoPurpose: We present our initial experience with a modified IRIS U-kit system (MIUS) (Stryker, USA) for real-time esophageal visualization during Nissen fundoplication (NF) surgery in pediatric patients, aiming to enhance safety and reduce complications, especially in cases involving esophageal dysmotility and neurological impairments. Methods: A retrospective, experimental study from April to June 2023 including patients with Gastroesophageal Reflux Disease (GERD). The IRIS U-kit, originally designed for urology, was adapted to aid esophageal visualization. This system utilized an illuminated ureteral stent with optical fibers inserted into a feeding tube (bougie). Results: Five pediatric patients with an average age of 6.2 years successfully underwent laparoscopic NF. Three patients had neurological impairments, one had trisomy 21, and one had no neurological issues. Using MIUS enabled real-time esophageal visualization throughout the surgery, even in challenging areas affected by periesophagitis. No complications were reported. All NF procedures, with or without additional interventions like gastrostomy and pyloroplasty, were completed safely. Discussion: NF surgery in pediatric patients, especially those with neurological impairments, poses risks of complications including perforations. Real-time esophageal visualization using the MIUS proved valuable in enhancing surgical safety, preventing complications and as an educational tool for resident training. Conclusions: The MIUS demonstrated feasibility and safety in NF surgery for pediatric patients, even in cases with esophageal dysmotility and neurological impairments without using endoscopy. This innovative approach has the potential to be applied in reoperations, Heller myotomies, and esophageal atresias. To our knowledge, this is the first successful use of the IRIS system in non-urological patients.http://www.sciencedirect.com/science/article/pii/S2949711625000103IVCase series with no comparison group |
| spellingShingle | Joel Cazares Eduardo De la Rosa-Bustamante Jorge Colín-Garnica Arturo Guillen-Cárdenas Marbella Sepulveda-Valenzuela Miguel Torres-Salas Jorge Alberto Cantú-Reyes Modified iris system: initial experience with a new technology for safety in hiatal surgery in pediatric patients Journal of Pediatric Surgery Open IV Case series with no comparison group |
| title | Modified iris system: initial experience with a new technology for safety in hiatal surgery in pediatric patients |
| title_full | Modified iris system: initial experience with a new technology for safety in hiatal surgery in pediatric patients |
| title_fullStr | Modified iris system: initial experience with a new technology for safety in hiatal surgery in pediatric patients |
| title_full_unstemmed | Modified iris system: initial experience with a new technology for safety in hiatal surgery in pediatric patients |
| title_short | Modified iris system: initial experience with a new technology for safety in hiatal surgery in pediatric patients |
| title_sort | modified iris system initial experience with a new technology for safety in hiatal surgery in pediatric patients |
| topic | IV Case series with no comparison group |
| url | http://www.sciencedirect.com/science/article/pii/S2949711625000103 |
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