Drug Protects Kidneys After Transplant
A new drug — a co-stimulatory blocker called belatacept (LEA29Y) that selectively blocks immune responses — has proved as effective in preventing acute kidney transplant rejection as cyclosporine, the standard anti-rejection treatment.

UCSF Launches Intestinal Rehab Program
A new Intestinal Rehabilitation and Transplantation Program treats children and adults with intestinal failure.

Minimally Invasive Surgery

"Little people, little incisions" is the credo of UCSF pediatric surgeon Hanmin Lee, M.D., an international leader in minimally invasive pediatric surgery. This includes minimally invasive repair of relatively rare and complex conditions, such as biliary anomalies and correction of common conditions such as inguinal hernia.

The move to minimally invasive surgery has been driven by improved instrumentation, including improved imaging technology, and the desire to reduce surgically induced trauma at an already difficult time in the child's life. The new approaches decrease hospital stays, speed recovery and have improved cosmetic results, Lee said. Children ranging in age from newborns to teens come to UCSF Children's Hospital from all over Northern California and elsewhere in the United States for this "less-is-more" surgery.

Laparoscopic Repair of Pyloric Stenosis — This procedure speeds the healing process following correction of this relatively common condition. Postoperative incisions are practically invisible, whereas the traditional technique leaves a scar that grows with the child. With this minimally invasive approach, children begin feedings within hours of surgery, which allows them to be discharged the day of surgery.

Laparoscopic Repair of Inguinal Hernia — Unilateral and bilateral inguinal hernias can be repaired in children under 6 months of age with laparoscopic techniques.

Laparoscopic Repair of Esophageal Atresia and Tracheoesophageal Fistula — Most esophageal anomalies can be repaired with minimally invasive approaches. Esophageal lengthening procedures allows surgeons to repair long-gap esophageal atresia in a single operation during the early newborn period. Early repair avoids prolonged hospitalization and the development of feeding problems.

Laparoscopic Repair of Biliary Atresia and Choledochal Cyst — The UCSF Children's Hospital group was the first in the United States to report laparoscopic repair of biliary atresia and choledochal cysts. Complex reconstruction appears to be possible in most patients, and reduces scarring in those patients who ultimately require liver transplants.

Consultations and Referrals

For information about UCSF Pediatric Surgery, call (415) 476-2538 or email pedsurg@surgery.ucsf.edu.

Fall 2005 Table of Contents

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