Prospective study of laparoscopic surgery in paediatric patients

ABSTRACT

Background: Laparoscopic cholecystectomy and laparoscopic appendectomy is gold standard treatment modality for symptomatic cholelithiasis and appendicitis. Laparoscopy in paediatric patient have many limitations and  factors restricting its use in paediatric patient are smaller surface area for access, compliant abdominal wall,  the liver margin  below the rib cage, the bladder being  an intra-abdominal structure, the viscera close to  anterior abdominal wall and small sized abdominal cavity and conventional instruments too long for paediatrics use.  The so-called obliterated structures like umbilical vein, umbilical artery and urachus remain relatively large and partially patent in infants further restricting use of therapeutic laparoscopy.Methods: The present study was carried out in Department of General Surgery, MDM Hospital, Dr. S. N. Medical College, Jodhpur, Rajasthan. Total 50 patients were included in the present study of laparoscopic surgery in paediatric patients below 14 years of age and were studied in terms of, duration of surgery, postoperative pain, analgesic requirement, postoperative hospital stay, intraoperative and postoperative complication and factors necessitating conversion of laparoscopic procedure to open method.Results: As per the present study inguinal hernia was most common diagnosis (48%) followed by hydrocele (22%) and acute appendicitis (22%).Conclusions: It is concluded from the present study that laparoscopic surgery in paediatric patients is safe, complication free, had less analgesic requirement, shorter duration of surgery, short postoperative hospital and total hospital stay and better cosmetic results.