Comprehensive Pediatric Minimal Access Surgery Program Available at Morgan Stanley Children's Hospital

May 20, 2005


Morgan Stanley Children's Hospital of NewYork-Presbyterian is now equipped with a new operating room, dedicated to pediatric minimal access surgery (MAS). The new OR-1™ integrated operating room, along with other minimal access technologies and expertise makes Morgan Stanley Children's Hospital one of the most comprehensive and child-friendly MAS programs in the nation.

Pediatric minimal access surgery, available to newborns and children of all ages, encompasses a wide range of procedures performed through small "keyhole" incisions rather than large incisions through the chest, abdomen, or other part of the body. With MAS, surgeons use instruments and video equipment to perform the surgeries through the smaller opening. Benefits of MAS include reduced pain and less need for pain medication, better cosmetic results (minimal scars), less blood loss, and shorter hospital stays.

"In addition to going home from the hospital sooner, children and their parents can return more quickly to normal activity, including school and work," says Dr. Jeffrey L. Zitsman, director of pediatric minimal access surgery at Morgan Stanley Children's Hospital of NewYork-Presbyterian and associate clinical professor of surgery at Columbia University College of Physicians and Surgeons. In many cases, recovery time is half that of traditional open surgery.

Minimal access procedures currently available at Morgan Stanley Children's Hospital for pediatric surgical cases include all manner of abdominal and thoracic procedures, with a total of 260 cases performed in 2004. This number has more than tripled since 2000. The most common minimal access procedures are appendectomies, lung decortication, and fundoplication for gastroesophageal reflux disease (GERD).

Minimal Access Surgery at Morgan Stanley Children's Hospital

Morgan Stanley Children's Hospital has been a leader in MAS for children for more than a decade. A team of specialized surgeons and operating room staff trained in the latest minimal access techniques uses the latest specialized equipment in a child- and parent-friendly environment.

"We are the only hospital regionally to offer minimal access surgical repair of so-called sunken or funnel chest, a congenital defect that can result in significant disfigurement of the child's chest wall," says Dr. Charles J. Stolar, chief of the division of pediatric surgery at Morgan Stanley Children's Hospital and the Rudolph N. Schullinger Professor of Pediatric Surgery at Columbia University College of Physicians and Surgeons. The minimally invasive Nuss Procedure, or Video-Assisted Pectus Excavatum Repair, named after its inventor, Dr. Donald Nuss of Children's Hospital of the King's Daughters (Norfolk, VA), allows for a complete repair without the need for a highly invasive procedure involving rib resections and fracture of the sternum.

For children with a hernia on one side of their groin area, Morgan Stanley Children's Hospital has led the use of a specialized laparoscope for the minimally invasive exploration for hernia on the opposite side. A small percentage of children with a hernia in the groin area have a hernia on the opposite side and, traditionally, when the hernia is repaired on one side, the surgeon will make an incision on the opposite side for exploratory purposes. The laparoscopic procedure can eliminate the need for a second incision.

The OR-1 Operating Room

The operating room opened its doors in January 2005. At its heart, OR-1 (Karl Storz Endoscopy-America, Inc.) is a computer system that allows the surgeon to control every aspect of the operating room, from accessing a patient's X-ray images or lab results, to controlling the lighting and temperature levels. Four separate monitors can display live video from the surgery (such as from an endoscope) or any relevant patient information, a teleconference and the ability to record video onto DVD. The system is also an ideal teaching tool because its viewing monitors enable anyone in the OR to see what is happening.

"Surgery is all about seeing, and this system gives us a perfectly beautiful image," says Dr. Stolar.

The OR-1 provides centralized management of up to 31 separate medical devices, as well as an unlimited number of environmental controls. Additionally, the system allows medical device settings to be preprogrammed according to procedure specifications and surgeons' preferences. In short, OR-1 allows the surgeon and nurses to focus on the patients and procedure instead of the equipment.

Karl Storz

Karl Storz Endoscopy-America, Inc. is an affiliate of Karl Storz GmbH & Co. KG (, an international leader for more than 50 years in reusable endoscope technology, encompassing all endoscopic specialties. Based in Tuttlingen, Germany, Karl Storz GmbH & Co. KG is a family-owned company that designs, engineers, manufactures and markets all of its products with an emphasis on visionary design, precision craftsmanship and clinical effectiveness.

Morgan Stanley Children's Hospital of NewYork-Presbyterian

Ranked by U.S.News & World Report as one of the top five children's hospitals in the country, Morgan Stanley Children's Hospital of NewYork-Presbyterian offers the best available care in every area of pediatrics – including the most complex neonatal and critical care, and all areas of pediatric subspecialties – in a family-friendly and technologically advanced setting. Building a reputation for more than a century as one of the nation's premier children's hospitals, Morgan Stanley Children's Hospital of NewYork-Presbyterian is affiliated with Columbia University College of Physicians and Surgeons, and is New York City's only hospital dedicated solely to the care of children and the largest provider of children's health services in the tri-state area with a long-standing commitment to its community. Morgan Stanley Children's Hospital of NewYork-Presbyterian is also a major international referral center, meeting the special needs of children from infancy through adolescence worldwide.