Abstract
The spectrum of laparoscopic surgery in children has undergone a dramatic evolution. Initially used as a diagnostic modality for many pediatric urologists, complex as well as reconstructive procedures are now being performed laparoscopically. Laparoscopic orchiopexy and nephrectomy are well established and are being performed at many centers. Laparoscopic partial nephrectomy, adrenalectomy, and dismembered pyeloplasty series have reported shortened hospital stays and operative times that are comparable to that of open techniques or are decreasing with experience. The initial experiences with laparoscopic ureteral reimplantation and laparoscopic-assisted bladder reconstructive surgery have been described, reporting encouraging results with regards to feasibility, hospital stay, and cosmetic outcome. This report will provide a directed review of the literature to establish the current indications for laparoscopy in pediatric urologic surgery.
Highlights
Advances in Pediatric Urologic LaparoscopyDivision of Pediatric Urology, Children's Hospital of Pittsburgh, Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
In the only retrospective comparison between laparoscopic and open pyeloplasties published to date, Bonnard et al.[63] reported a significant decrease in both hospital stay (2.4 vs. 5 days) and postoperative acetaminophen requirement for patients undergoing retroperitoneal laparoscopic pyeloplasties, but a significantly longer mean operative time (219 vs. 96 min)
In a comparison between laparoscopic pyeloplasty performed with the da Vinci (Intuitive Surgical, Sunnyvale, CA) robotic system matched to procedures performed with standard laparoscopic techniques, Gettman et al.[123] reported decreased operative times with robotic-assisted pyeloplasty compared with standard laparoscopic pyeloplasty
Summary
Division of Pediatric Urology, Children's Hospital of Pittsburgh, Department of Urology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania. Used as a diagnostic modality for many pediatric urologists, complex as well as reconstructive procedures are being performed laparoscopically. Laparoscopic orchiopexy and nephrectomy are well established and are being performed at many centers. Laparoscopic partial nephrectomy, adrenalectomy, and dismembered pyeloplasty series have reported shortened hospital stays and operative times that are comparable to that of open techniques or are decreasing with experience. The initial experiences with laparoscopic ureteral reimplantation and laparoscopic-assisted bladder reconstructive surgery have been described, reporting encouraging results with regards to feasibility, hospital stay, and cosmetic outcome. This report will provide a directed review of the literature to establish the current indications for laparoscopy in pediatric urologic surgery
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