[Minimally invasive surgery in pediatric patients within a general urology department].
OBJECTIVE
The advances of minimally invasive surgery in urology over the last years have enabled a progressive and constant implementation of endourology and laparoscopy in pediatric patients. We perform a review of our experience, as a general hospital, with minimally invasive surgery performed in pediatric patients over the last ten years.


METHODS
We retrospectively analyzed the endourological and laparoscopic operations performed between 1997 and 2007 in children up to the age of 16 years, collecting data about patient's age and gender, type of disease, techniques, anesthesia, and perioperative events.


RESULTS
seventy-two surgical operations were performed in patients with an age range between 28 days and 16 years, with a mean age of 6.8 years. 56% of the patients were boys and 44% girls. Indications for surgery was vesicoureteral reflux (VUR) in 28 cases (38.8%); lithiasis 17 cases (23.6%) which were distributed in 4 cystolithotripsies, 9 ureterorenoscopy with lithotripsy, one pure percutaneous nephrolithotomy and three mixed; ureterocele 9 cases (12.5%); urethral obstruction 7 cases (9.7%); 3 diagnostic laparoscopies for cryptorchidism (4. 1%), 2 laparoscopic procedures for cystic pathology (2.7%), another 2 laparoscopic renal biopsies (2.7%), and one laparoscopic repair of a ureteropyelic junction syndrome; 1 case of emergency percutaneous nephrostomy in the supine position after open pyeloplasty with subsequent reoperation with percutaneous resection of a granuloma; and 1 case of botulin toxin injection into the detrusor muscle.


CONCLUSIONS
The consolidation of pediatric endourology in our department, and more recently laparoscopy, has contributed to improve the quality of care in pediatric patients; it has been achieved thanks to our previous know-how in general endourological techniques and the existence of adequate technical and human resources.
Ríos
Jorge Subirá
JS
Servicio de Urología, Hospital Clínico Universiario Lozano Blesa, Zaragoza, España. kokedoc@hotmail.com
Zalabardo
José Manuel Sánchez
JM
Gil
Joaquín Navarro
JN
Conejos
José Ignacio Hijazo
JI
Alonso
Jesús García-Magariño
JG
Calero
David García
DG
López
José Antonio López
JA
Uría
José Gabriel Valdivia
JG
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010535:Laparoscopy; D008297:Male; D019060:Minimally Invasive Surgical Procedures; D012189:Retrospective Studies; D014570:Urologic Diseases / Q000601:surgery*; D014573:Urology Department, Hospital