Twelve years of minimally invasive surgery in children and adolescents: a single center experience.
OBJECTIVE
Minimally invasive surgery plays an important role in the daily practice of pediatric surgeons. However, there have been few reports of large series of patients. The aim of this paper is to report our experience over the past 12 years with a broad range of pediatric laparoscopic procedures.


METHODS
We performed a retrospective analysis of 1084 minimally invasive procedures conducted in the department of pediatric surgery from June 1992 to March 2004.


RESULTS
The mean age of the patients was 14 years (range, 1-19). Seven hundred forty-six operations (69%) were thoracoscopic sympathectomy for hyperhydrosis. Other common operations were high ligation of spermatic vessels (n=98), cholecystectomy (n=65), exploration of nonpalpable testes (n=53), appendectomy (n=55), female adnexal surgery (n=24), and splenectomy (n=13). Thirty miscellaneous procedures included Nissen fundoplication, liver biopsies, diagnostic laparoscopy, Morgani and Bochdalek hernia repair, Swenson procedures, V-P shunt placement, splenic and hepatic cyst removal, thorcoscopy for pleural empyema, treatment of gastric ulcer perforation, and nephrectomy. We reviewed the indications for surgery, the surgical technique, and the outcome for each procedure. All patients in this series were well at follow-up and there was no long-term morbidity.


CONCLUSIONS
Although laparoscopic procedures have gained an integral place in pediatric surgery and are relatively safe, advanced laparoscopic procedures should be developed, practiced and evaluated in dedicated surgical units to ensure a broad base of experience on which to base future decisions and guidelines.
Karplus
Gideon
G
Department of Pediatric Surgery, Soroka University Medical Center, Beer-Sheva, Israel.
Kleiner
Oleg
O
Newman
Nitza
N
Finaly
Robert
R
Mordehai
Jacob
J
Avinoah
Eliezar
E
Cohen
Zahavi
Z
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007557:Israel; D010535:Laparoscopy; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies