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Minimally invasive surgery for urologic disease in children

Nature Clinical Practice Urology volume 4, pages 26–38 (2007)Cite this article

Abstract

This article is a comprehensive review of the current indications and recent literature pertaining to laparoscopic techniques in pediatric urology. Basic concepts such as instrumentation, anesthetic considerations, and complications are reviewed. Specific techniques and indications are also explored. As the field of pediatric urology continues to expand, it still lags behind adult urology. With improvements in technology, however, and with new surgeons entering the field with a basic laparoscopic background, pediatric urologic laparoscopy continues to progress. Currently, procedures such as laparoscopic exploration for undescended testicles and laparoscopic nephrectomy are accepted as the 'gold standard', and are performed at most institutions. Other procedures, such as laparoscopic pyeloplasty and laparoscopic reconstructive surgery, have only recently been introduced and are primarily available at centers with surgeons experienced in laparoscopy. It is our hope that minimally invasive surgical approaches to urologic conditions will become available to all children and become commonplace at most institutions.

Key Points

  • The spectrum of laparoscopic urologic surgery in children continues to expand, although it still lags behind adult laparoscopic urologic surgery

  • The techniques that were developed in adults have been refined for the pediatric population and have expanded the field from merely diagnostic procedures to include complex reconstructive surgeries

  • The benefits of laparoscopy include improved cosmesis, reduced postoperative morbidity, shorter convalescence, and increased magnification and visualization of the surgical field

  • As the field continues to develop with improvements in technology and the number of pediatric surgeons with backgrounds in basic laparoscopy increases, pediatric urologic laparoscopy will continue to progress

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Figure 1: Laparoscopic images taken during diagnostic laparoscopy for cryptorchidism.

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Authors and Affiliations

  1. at the Department of Urology at the University of Pittsburgh Medical Center, DD Sweeney is the Chief Resident of Urology, MC Smaldone is a Resident of Urology, and SG Docimo is a Professor of Urology and the Vice Chairman, Children's Hospital of Pittsburgh, Pittsburgh, PA, USA.,

    Danielle D Sweeney, Marc C Smaldone & Steven G Docimo

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  1. Danielle D Sweeney
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  2. Marc C Smaldone
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  3. Steven G Docimo
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Correspondence to Danielle D Sweeney.

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Sweeney, D., Smaldone, M. & Docimo, S. Minimally invasive surgery for urologic disease in children. Nat Rev Urol 4, 26–38 (2007). https://doi.org/10.1038/ncpuro0677

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