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PEDIATRICS Vol. 111 No. 6 June 2003, pp. 1239-1252

REVIEW ARTICLE

Current Concepts in Minimal Access Surgery for Children

Jeffrey L. Zitsman, MD

From the Children’s Hospital of New York Presbyterian, College of Physicians and Surgeons, Columbia University, New York, New York

Since the introduction of minimal access surgery to general surgeons in the 1980s, pediatric surgeons have been employing this innovative technology to perform surgery on children. Video technology and miniaturized instruments have brought the laboratory to the operating room; in many cases several small incisions are the only access necessary to perform complicated procedures that would otherwise require a large wound. Additional benefits of minimal access surgery may include reduced postoperative analgesic requirements, shortened length of stay, and faster resumption of normal activities. Increased operative costs offset some of these gains. The pediatric surgical community has embraced minimal access techniques for some operations; others remain controversial.

Key Words: laparoscopy • minimal access surgery • minimally invasive surgery • thoracoscopy

Abbreviations: MAS, minimal access surgery • CT, computerized tomography • LA, laparoscopic appendectomy • OA, open appendectomy • LC, laparoscopic cholecystectomy • CBD, common bile duct • LS, laparoscopic splenectomy • GERD, gastroesophageal reflux disease • LNF, laparoscopic Nissen fundoplication • ONF, open Nissen fundoplication • PEG, percutaneous endoscopic gastrostomy • OP, open pyloromyotomy • LP, laparoscopic pyloromyotomy • L-A, laparoscopically assisted • MD, Meckel’s diverticulum • ID, intestinal duplication

Received for publication Nov 4, 2002; Accepted Dec 10, 2002.




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