Pediatric Laparoscopic and Robot-Assisted Laparoscopic Surgery: Technical Considerations

Abstract

Laparoscopy has become an effective modality for the treatment of many pediatric urologic conditions that need both extirpative and reconstructive techniques. Laparoscopic procedures for urologic diseases in children, such as pyeloplasty, orchiopexy, nephrectomy, and bladder augmentation, have proven to be safe and effective with outcomes comparable to those of open techniques. Given the steep learning curve and technical difficulty of laparoscopic surgery, robot-assisted laparoscopic surgery (RAS) is increasingly being adopted in pediatric patients worldwide. Anything that can be performed laparoscopically in adults can be extended into pediatric practice with minor technical refinements. We review the role of laparoscopic and RAS in pediatric urology and provide technical considerations necessary to perform minimally invasive surgery successfully.

Training potential in minimally invasive surgery in a tertiary care, paediatric urology centre

“…MIS is more expensive than the standard open procedures because of the need for specialized instruments, intensive training and extended operation times. In contrast, the hospital stay is generally shorter after MIS, resulting in reduced costs and a faster return to normal activities [2,3,7,11]. From the socioeconomic viewpoint, a child's early return to normal activity after laparoscopic surgery does not directly add productivity, but their parents' earlier resumption of work does.…”

“…Laparoscopy has been shown to be effective and safe with a low morbidity rate [2,6,7]. It is known to have a steep learning curve due its technical challenges.…”

Laparoendoscopic Single-Site (LESS) Surgery in Pediatric Urology: A 4-Year Experience

“…Laparoscopic urological surgery has rapidly evolved in pediatric urology and has become standard in urological practice [1]. Recent improvements in laparoscopic surgical techniques led to the introduction of laparoendoscopic single-site (LESS) surgery.…”

How to decide which infant can have robotic surgery? Just do the math

“…The use of robotic technology was initially utilized for pyeloplasty and nephrectomy, but its use has now expanded to most areas of pediatric urology, including more complex reconstructive surgeries [1,2]. Roboticassisted surgery offers highly magnified three-dimensional visualization that can be combined with tremor filtration and motion scaling, which allows for delicate movements in small areas.…”