Current Trends in Pediatric Minimally Invasive Urologic Surgery

Abstract

Over the past two decades, laparoscopic and robotic surgery in children has been described as a viable minimally invasive alternative to open surgery for many pediatric urologic conditions. With the goal of reducing the morbidity associated with open surgery, minimally invasive surgery in children is increasingly being performed as laparoscopic and robotic patients appear to be experiencing shorter hospital stays, decreased pain medication requirements, and the potential for improved cosmesis. This article provides an overview of the existing literature in laparoscopic and robotic-assisted laparoscopic urologic surgery in children. Laparoscopic and robotic-assisted laparoscopic surgery appears to be safe and effective in children for a wide range of ablative and reconstructive procedures. Conventional laparoscopic surgery is effective for ablative procedures, while robotic surgery may be ideally suited for reconstructive cases requiring advanced suturing and dissection. Overall, more prospective studies are needed to study the long-term outcomes of minimally invasive surgery in pediatric patients, and the appropriate use of the available technology.

Current Trends in Pediatric Robotic Surgery

“…In a different report , Casale focuses on robotic pyeloplasty in children, which is the most widely performed robotic procedure in pediatric urology 115 . Another recent review article describes the current trends in pediatric minimally invasive urologic surgery 116 . Experiences described include adrenalectomy, nephrectomy, partial and heminephrectomy, pyeloplasty, ureteral reimplantation and lower urinary tract reconstruction.…”

Current controversies in pediatric urologic robotic surgery

“…Despite its popularity, there is a paucity of data (seven series) regarding its long-term, clinical outcome [4 && ]. However, laparoscopy pyeloplasty [5] and RALP [6,7] are associated with lower requirement for and quicker cessation of pain medication and shorter mean length of hospitalization than with open dismembered pyeloplasty. The current literature suggests that the longterm success rate is similar between that of open dismembered pyeloplasty, laparoscopy pyeloplasty and RALP.…”

“…In addition, it may be ideal for teaching robotic surgery as nephrectomy is a relatively simple ablative procedure that does not require significant reconstructive capabilities and, thus, can provide training for more complex procedures [5]. The laparoscopic approach is well tolerated and offers significant advantages over open surgery including decreased postoperative pain, shorter hospitalization and improved cosmesis.…”

Validation of the three web quality dimensions of a minimally invasive surgery e-learning platform

“…Thus, it is possible to perform MIS procedures that have advantages over open surgery. The benefits include the optimisation of resources in health systems and, regarding patients, shorter and less painful post-operative care, less tissue trauma, shorter hospital stays and faster recovery, allowing for a swifter return to daily life [1][2][3][4]. However, MIS also has some drawbacks [5,6], mainly related to spatial and technical limitations, that must be addressed with tremendous specialised training in specific MIS skills.…”