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Volume 4 Journal of Pediatric Care
ISSN: 2471-805X
Page 11
Notes:
May 07-08, 2018 Frankfurt, Germany
&
JOINT EVENT
3rd International Conference on Pediatrics and Pediatric Surgery
22nd Edition of International Conference on Neonatology and Perinatology
Michael Stark
New European Surgical Academy, Germany
Michael Stark, J Pediatr Care, Volume 4
DOI: 10.21767/2471-805X-C2-007
The evidence-based C-section and the risks involved in the exaggeration of its use
As most abdominal operations have endoscopic alternatives, caesarean section will remain the only abdominal operation
in the future. Therefore it is of utmost importance to constantly evaluate the different steps for their necessity and for
their optimal way of performance. The modified Joel-Cohen method results in a shorter incision to delivery time, lower rate
of febrile morbidity compared to the traditional Pfannenstiel incision. Opening peritoneum using bi-digital stretching rather
than sharp instruments proved to be safer, and exteriorization of the uterus makes stitching easier and avoids unnecessary
bleeding. Suturing the uterus with one layer only results in stronger scars and reduced pain. Leaving both peritoneum layers
open reduces adhesions. The fascia being sutured continuously with first knot underneath the fascia prevents irritation in
the sub-cutis and by a right-handed surgeon, from the right to the left, proved to be ergonomic. Since the introduction of
this modified and simplified method, it has been evaluated in dozens of peer-reviewed publications from different countries.
Without exception, all showed various advantages of this method: shorter operation time, shorter hospitalization, quicker
mobiliza¬tion, less blood loss, lower rate of febrile morbidity, lower costs, and less need for painkillers. Only 10 instruments
and three sutures are needed, which simplifies the workload of nurses. In order to standardize this operation, it is important
to use constantly the same needles and instruments. Big needle is necessary for the uterus, as fewer steps are done and
therefore less foreign body reaction. This operation is recommended as universal routine method for caesarean section and
its principles should apply to all surgical disciplines. Unfortunately, the rate of cesarean section is rising constantly around the
world. As evolution continues, it might be influenced by this high rate. In this presentation, the logic of the need to limit the
numbers of cesarean section based on anthropological studies will be presented.
Biography
Michael Stark specializes in Obstetrics and Gynecology and his main interest is Gynecological Oncology. He initiated the VIEZION project which combines targeted che-
motherapy, PIF and stem-cell therapy for improving post-surgical oncological treatment. He is currently the Scientific and Medical Advisor of ELSAN, a 120 hospital group
in France and is a guest Scientist at the Charite’s University Hospital in Berlin. Since 2004 he has been the President of the New European Surgical Academy (NESA), an
international inter-disciplinary surgical organization with members in 54 countries and a formal cooperation agreement with FIGO concerning transmission of knowledge to
countries with limited resources. In 2011, he was nominated as the Medico DelAnno (Doctor of the Year) in Italy, and is an Honorary Member of the French, Polish, Russian
and Italian Gynecological Associations. In the years 1983-2000 he was the Medical Director and Head of Ob/Gyn Department of the Misgav Ladach General Hospital in
Jerusalem, and between 2001 and 2009 the chairman of all Ob/Gyn Departments of the HELIOS Hospital Group in Europe. He was the Scientific Director of the European
novel tele-surgical system. He was visiting Professor at the Universities of Toronto, Moscow, Beijing, Milan, Adana, Uppsala and the Weill-Cornell University Hospital in
New York. He modified operations like the vaginal and abdominal hysterectomy and cesarean section and developed the concept of single-entry natural orifice surgery.
He was involved in the development of the trans-oral thyroidectomy and transdouglas abdominal surgery.