Minimally invasive pediatric urologic surgery: what can we do today?

Urologic minimally invasive surgery is now routinely used for basic surgical procedures in most centers. Lately, in selected centers around the world, it has been ever more applied in more complex surgeries. We present an overview of urologic pathology which is currently treated with minimally invasive approach and highlight some relevant articles that were discussed and compared with the experience of the Department of Pediatric Surgery, Zagreb Children’s Hospital. Since the introduction of minimally invasive surgery at our Department of Pediatric Surgery, more than 1300 children with various urologic pathologies have been operated on. Three approaches were used: transperitoneal, retroperitoneal and transvesical. The largest number of operations belonged to endoscopic treatment of vesicoureteral refl ux. Besides vesicoureteral refl ux, the indications for using minimally invasive procedures were impalpable testes, varicocele, nephrectomy and adrenalectomy. Even the most complex urologic surgeries can be performed using the minimally invasive approach, although most reported cases fall into the category of “case report”. Lately we have witnessed a number of publications on the ablative and reconstructive minimally invasive surgery. Transperitoneal and retroperitoneal approaches are used with quite comparable results. Transvesicoscopic surgery should develop rapidly and become a standard approach for Cohen’s reimplantation. It is believed that technical advancements will provide an opportunity for pediatric urologists to develop minimally invasive procedures.
Keywords: minimally invasive surgery, pediatric urology, transabdominal approach, retroperitoneal approach, transvesical approach
Category: Review
Volume: Vol. 60, No 3, july - september 2016
Authors: B. Župančić, M. Bašković, S. Višnjić, I. Vukasović
Reference work: Paediatr Croat. 2016;60:91-6

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