Clinical Experiences of Laparoscopic Surgery in Children

ABSTRACT

PURPOSE: The indications for pediatric laparoscopic surgery are increasing according to the improvement of laparoscopic procedures and instruments and the increased knowledge of its safety and benefits. We summarized the analysis of the outcomes and the feasibility of performing laparoscopic surgery in children. METHODS: We retrospectively analyzed 183 consecutive children (114 males and 69 females) who underwent laparoscopic surgery between June 2001 and July 2007. The following information was obtained the surgical indications, operative procedures and surgical outcomes. RESULTS: The laparoscopic procedures for each disease were as follows, appendectomy for acute appendicitis (n=143), reduction for barium reduction-failed intussusceptions (n=15), splenectomy for symptomatic hereditary spherocytosis (n=5), salphingoophorectomy for torsion of a parovarian cyst and ovarian tumor (n=2), diverticulectomy or segmental resection for symptomatic Meckel's diverticulum (n=3), cholecystectomy for symptomatic gall stones & adenomyomatosis (n-4), repair for Morgagni hernia (n=1), Nissen's fundoplication for paraesophageal hernia (n=1), Heller myotomy and Dor fundoplication for achalasia (n=1), diagnostic purpose for peritoneal tuberculosis (n=3) and lymphoma (n=1), excision for retroperitoneal neuroblastoma (n=1), peritoneal drainage for postoperative abscess (n=1) and removal of a foreign body in the peritoneal cavity (n=2). The mean age was 9.9 years (range 4 months to 15 years). There was one conversion for a perforated appendicitis. There were 3 cases of laparoscopic assisted reductions for intussusception. There were three wound infections in the patients with complicated appendicitis. CONCLUSION: Laparoscopic procedures for various pediatric surgical disorders were feasible under the appropriate indications.