title: Minimally-invasive pediatric surgery in 2004: a survey including 50 German institutions.
abstract: BACKGROUND
  A survey on the practice of laparoscopic and thoracoscopic surgery in pediatric surgical departments in Germany is presented.
  
  
  METHODS
  A questionnaire was sent to all 71 pediatric surgical departments in Germany (population 82 million). Fifty institutions (70%) took part in the survey that mainly included data for the year 2004: spectrum of minimally invasive operations, quantity of procedures, conversions, major complications, number of performing surgeons and residents.
  
  
  RESULTS
  Laparoscopic techniques were used in 48 departments (96%) and thoracoscopic techniques in 37 (74%). The annual frequency of laparoscopies was less than 100 in 30 departments (62%) and more than 100 in 15 (31%). The number of thoracoscopies was less than 50 in 35 departments (73%) and more than 50 in 2 (4%). Appendectomy was offered in 45 (90%), varicocelectomy in 32 (64%), and Fowler-Stephens operation in 33 (66%). Twenty-one departments (42%) covered more advanced procedures such as laparoscopically assisted pull-through for Hirschsprung disease. Most demanding procedures such as laparoscopic choledochal cyst resection, duodeno-duodenostomy, heminephrectomy, or pyeloplasty were offered by 10 departments (20%). Minimally invasive surgery was performed by 1 surgeon (12%) in 6 institutions and by more than 5 surgeons (14%) in 7 institutions.
  
  
  CONCLUSIONS
  Minimally invasive techniques are increasingly accepted in most German pediatric surgical institutions for a wide range of indications. However, the number of departments offering major minimally invasive procedures remains limited.
authors.affiliation: Department of Pediatric Surgery, Medical University Hanover, 30625 Hannover, Germany.
authors.forename: Annika I
authors.initials: AI
authors.lastname: Schmidt
authors.forename: Carsten
authors.initials: C
authors.lastname: Engelmann
authors.forename: Holger
authors.initials: H
authors.lastname: Till
authors.forename: Stephan
authors.initials: S
authors.lastname: Kellnar
authors.forename: Benno M
authors.initials: BM
authors.lastname: Ure
mesh_terms: D002648:Child; D005858:Germany; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000706:statistics & numerical data*; D013906:Thoracoscopy / Q000706:statistics & numerical data*