Background/Purpose: 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.
Conclusion: 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.
