Laparoscopic and robotic surgery in pediatric urology

Abstract

Minimally invasive technology has been embraced in the surgical area over the past 10 years, with laparoscopy leading the way. In the adult population, there are clear advantages in the risk–benefit paradigm. In pediatric surgical procedures, however, the enthusiasm has been dampened by the fact that children in general have a quicker postoperative recovery after open surgery compared with adults, and the risk–benefit ratio is not as obviously in favor of minimally invasive approaches. Instrumentation that is specific to pediatric patients often has lagged behind other technologic advances. In spite of these considerations, advancements in laparoscopy and robotic assisted surgery have been demonstrated to be advantageous for certain procedures. This article details procedures that are possible in pediatric patients. As further technical advancements are made, these procedures may become the standard of care in children, reaching toward the goal of lessening pain and recovery time while maintaining excellent surgical success. Diagnostic laparoscopy The primary indication for diagnostic intra-abdominal laparoscopy is indicated for the nonpalpable testes or to define intra-abdominal internal ductal or gonadal structures in intersex cases.