Abstrakt Pediatrie Červen 2010

“Laparoscopic and robotic approach to genitourinary anomalies in children.”

Casale, P. (2010).

Urologic Clinics of North America 37(2): 279-286.


Minimally invasive surgery has revolutionized surgery for urologic disorders in pediatric patients. Laparoscopic procedures have become widely available for several different ablative and reconstructive operations in children. The success rates have paralleled those of open surgical techniques and provide the benefit of smaller incisions and less manipulation of tissue during the procedures. Robotics has enhanced these factors, coupled with increased dexterity, better visualization, and less fatigue, allowing greater precision. We must continue to evolve with the ever-changing advancements in technology and take a keen interest so that we can influence development. © 2010 Elsevier Inc.




“Single-incision laparoscopic surgery: feasibility for pediatric appendectomies.”

Oltmann, S. C., N. M. Garcia, et al. (2010).

Journal of Pediatric Surgery 45(6): 1208-1212.


Introduction: Single-incision laparoscopic surgery (SILS) is a novel area of minimally invasive surgery using a single incision. The end result is a lone incision at the umbilicus for a perceived scarless abdomen. We report our early experience using the SILS technique for appendectomies in the pediatric population. Methods: A retrospective chart review was performed on our first patients to undergo SILS appendectomy (SILS-A) or laparoscopic appendectomy (LAP-A) during the same period at a freestanding children’s hospital. Results: Thirty-nine patients were reviewed. Nineteen patients underwent SILS-A (8.7 ± 0.76 [SEM] years old), and 20 patients underwent LAP-A (10.5 ± 0.87 years old, 2-17). Ages were 19 months to 14 years in the SILS-A group, with 21% (4 patients) not older than 6 years. Median weight for SILS-A was 32 kg (14.5-80.3). Twelve patients had acute nonperforated appendicitis (62%). Mean duration of operation was 58 ± 5.6 (30-135) minutes vs 43 ± 3.6 (30-85) minutes for standard LAP-A. Two patients were converted to a transumbilical appendectomy, one for inability to maintain a pneumoperitoneum and one for extensive adhesions. Postoperative complications consisted of one wound seroma. No wound infections, hernias, readmissions, or difference in length of stay were noted. Conclusion: The SILS approach for acute appendicitis is feasible in the pediatric population even in patients as young as 19 months. Operating room times are somewhat longer than with LAP-A, but should decrease with improved instrumentation and experience. Larger studies and further technical refinements are needed before its widespread implementation. © 2010 Elsevier Inc. All rights reserved.