OBJECTIVE:This systematic review analyzed laparoscopic repair of primary hiatal hernia (HH) in children, focusing on presentation, diagnosis, surgical techniques and postoperative outcomes. METHODS:Studies published between 2000 and 2025 on laparoscopic repair of primary pediatric HH were identified according to PRISMA guidelines (PROSPERO: CRD420261295203). Due to heterogeneity in study design and outcome reporting, a meta-analysis was not feasible. Data were summarized descriptively. Selected comparisons used Fisher's exact test and odds ratios (ORs) with 95% confidence intervals (CIs)(p < 0.05) Results: Twenty-seven studies reporting 353 patients met the inclusion criteria. The evidence was of low certainty, consisting predominantly of case reports (n=12) and case series (n=10), with only five retrospective cohorts and no prospective studies. Estimated median age was 18.6 months (range 6 days-16 years). Gastroesophageal reflux disease was the most common symptom. Laparoscopic repair was performed in all patients, with 1.4% conversion rate and one intraoperative complication. Recurrence occurred in 21/331 (6.3%). Patch-reinforced repair showed a non-significantly higher recurrence rate than primary repair (OR 2.63, 95% CI 0.54-12.8; p=0.24). Esophageal stenosis was the most frequent postoperative complication (n=40/331; 12.1%) and was more common after Nissen-Rossetti than Thal fundoplication (OR 2.63, 95% CI 1.11-6.25; p=0.027), although heterogenous reporting and missing data limit this comparison. CONCLUSION:Laparoscopic repair of primary pediatric HH appears feasible, with low reported perioperative morbidity and acceptable recurrence rates, but evidence is low certainty. Fundoplication appears reasonable but the observed association of complete wraps with stenosis requires cautious interpretation.. Current evidence does not support routine patch reinforcement.

Introduction Management of testicular torsion varies between specialties resulting in lack of standardization. The aim of this survey was to assess pre-, peri-, and postoperative differences. Methods An online questionnaire was distributed in 2023 to general and pediatric surgeons, pediatric urologists, and urologists by the Trainees of European Pediatric Surgery. Main Results Among 88 respondents (92% tertiary referral hospital), 38% always or usually perform sonography in case of suspected torsion respectively. In addition, 15% always attempt manual detorsion and 44% depending on the clinical presentation. Most surgeons (93%) favor a scrotal approach. Interestingly, pediatric surgeons choose a transscrotal while other specialties opt for a midline incision ( p = 0.002). The majority (57%) employ a three-point fixation, while 42% opt for a two-point fixation. In case of necrotic testis, 61% puncture the testis with 52% opting for surgical removal, while 33% perform orchiectomy and 6% leave it in situ. Regarding necrotic or borderline-appearing testis, 54% take a biopsy. Furthermore, 82% perform prophylactic orchidopexy of the contralateral side during the same session. Postoperative antibiotics are always administered by 12%, while 52% do so sometimes. Most perform sonographic (58%) or clinical (57%) follow-up 3 months postoperatively. Notably, pediatric surgeons and urologists perform follow-up more frequently themselves, while general surgeons/urologists recommend follow-up by pediatricians ( p = 0.002). In addition, 76% of responders affirm adhering to European Association of Urology guidelines. Unawareness of guidelines and institutional practices are reasons most commonly cited for nonadherence. Conclusion Our study reveals significant disparities in the pre-, peri-, and postoperative management of testicular torsion underscoring the need for establishing standardized practices.

Die Duodenalduplikatur bleibt mit einer Inzidenz von 1 zu 5–10.000 Lebendgeburten eine der seltensten von allen angeborenen Fehlbildungen. Diese Duplikaturen sind extrem selten und machen nur 4–5

Duodenal duplication cyst remains one of the rarest congenital malformations with an incidence of 1 in 5-10,000 live births. Among them, the duplications affecting the duodenum are extremely rare, accounting for only 4-5% of the duplications of the digestive tract. We present a 6-month-old girl with recurrent, nonbilious vomiting. Abdominal sonography showed classical signs of duodenal duplication. Intraoperatively, the distal segment of the duplication showed a fistula-like canal pulling to the pyloric canal. Histologically, uncharacteristically ectopic pancreatic tissue was shown. The operation was successful. Postoperative follow-up was satisfactory. Surgical procedures include endoscopy, laparoscopy or open access. The prognosis after complete removal is excellent.

Background: Hypertrophic pyloric stenosis (HPS) and Esophageal Atresia (EA) are two distinct congenital malformations that rarely occur simultaneously. However, there have been reported cases of the simultaneous occurrence of HPS and EA, suggesting a potential relationship between these two conditions. The clinical features of the simultaneous occurrence of HPS and EA can be modified and the diagnosis may be delayed. Case presentation: We present a rare case of a newborn with simultaneous Type 3b esophageal atresia and hypertrophic pyloric stenosis. Following surgical correction of esophageal atresia, the patient exhibited symptoms of projectile vomiting, which were subsequently confirmed through ultrasound examination to be associated with hypertrophic pyloric stenosis. The patient was successfully managed through surgical intervention, and the outcomes were favorable. Conclusion: This case report aims to highlight the significance of preoperative screening for hypertrophic pyloric stenosis in patients diagnosed with esophageal atresia, based on current literature.