Frederick Pediatric Surgery in Paris at the Necker Enfants Malades Hospital

It often happens that great French surgeons are invited to Italy to operate on Italian patients, using new surgical techniques. This time the opposite happened. Professor Ciro Esposito, Director of the Complex Operative Unit of Pediatric Surgery at Policlinico Federico II, was invited to Paris, to the most important pediatric center in France, the well-known Necker Enfants Malades Hospital, to operate on 3 French patients suffering from a rare pathology of the sacro-coccygeal region: the pilo-nidal fistula.

Professor Esposito has, in fact, developed in 2016 a new endoscopic pediatric technique to treat pilonidal fistula. This technique is called PEPSIT (Pediatric Endoscopic Pilonidal SInus Treatment) and Prof. Esposito was awarded in September 2019 by Professor François Varlet President of the French Society in Strasbourg for having conceived it and described it in work published in'The Journal of Pediatric Surgery'.

'Pilonidal fistula,' Professor Esposito points out, 'is a chronic inflammatory pathology of the sacrococcygeal region that affects prepubescent boys and girls, the open surgical technique used to correct this pathology is very painful and requires a long hospital stay in addition to presenting a very high recurrence rate, between 20 and 40 percent. In fact, such pathology causes recurrent infections that require repeated antibiotic treatment and continuous discomfort for the patient'.

The endoscopic technique developed in the pediatric patient by Ciro Esposito and his team consists of introducing a micro-camera through the orifice of the fistula and treating the fistula from the inside without making incisions.

'The procedure,' adds Esposito,'is performed under Day Surgery and has a success rate of more than 95 percent. PEPSIT leaves no scars, except the small orifice of the fistula, and allows a pain-free postoperative and a rapid resumption of activities by the patient. This technique is not yet used in France, and I am really proud to have been invited by French colleagues to spread this minimally invasive technique.'

'Thanks to the excellence of care of the Pediatric Surgery of the Federico II University Hospital and the availability of highly technological operating rooms, we are progressively reversing the flow of health migration of pediatric patients, whose families often turn to health facilities in Rome or Northern Italy, with all the inconveniences that these choices entail. 'Today, considering that our pediatric surgery is recognized as a cutting-edge reality in Europe, particularly for minimally invasive techniques, patients from many Italian regions prefer to turn to the Policlinico Federico II in Naples, to be received and operated on,' stresses AOU Federico II General Director Lawyer Anna Iervolino.

Every year, more than 1,500 patients are operated on at the UOC of Pediatric Surgery, many of whom use laparoscopic, endourological and laser-assisted techniques.

In 2015, AOU Federico II Pediatric Surgery was, in addition, appointed as the National Reference Center for Laparoscopic and Minimally Invasive Pediatric Surgery, and in 2016, even for pediatric patients, it was possible to have the opportunity for surgeries performed with the new Davinci Robotic System, which allows surgery, in particular, in patients with malformations of the kidney and urinary tract, with greater precision than the open technique. (A.D.)