Minimally-invasive pediatric surgery in 2004: a survey including 50 German institutions.
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.
Schmidt
Annika I
AI
Department of Pediatric Surgery, Medical University Hanover, 30625 Hannover, Germany.
Engelmann
Carsten
C
Till
Holger
H
Kellnar
Stephan
S
Ure
Benno M
BM
D002648:Child; D005858:Germany; D006801:Humans; D010535:Laparoscopy / Q000706:statistics & numerical data*; D010372:Pediatrics / Q000706:statistics & numerical data*; D013906:Thoracoscopy / Q000706:statistics & numerical data*