By- Dr. Rasiklal Shah, Senior Consultant – Paediatric Surgery, SRCC Children’s Hospital, managed by Narayana Health
Laparoscopic intervention has revolutionized the world of surgery with its minimal invasiveness and reduced postoperative pain. While laparoscopic surgery is not new in the field of surgery, it has witnessed enormous progress in the last three decades, and in the field of paediatric surgery as well.
The first laparoscopic cholecystectomy was performed on an adult in 1986. Since then significant advancements in technology and techniques have happened in this field resulting in a very positive outcomes. Laparoscopic procedures in children, on the other hand, was remained restricted to diagnostic purposes till the 1980s. Paediatric surgeons in selected centres started performing paediatric laparoscopic procedures around the world. In India, advanced laparoscopic paediatric surgery was started in December 1998 by the author himself by performing the first laparoscopic Pull through surgery for Hirschsprung’s disease.
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It is estimated that over 80% of paediatric surgeons in the USA and many other countries perform laparoscopic surgery in recent times. At present, there are extensive applications of this technique, and several advanced-level intricate surgeries are performed safely even in small children. In India, more and more parents are opting for this kind of surgery due to its benefits.
Key Benefits Of Paediatric Laparoscopic Surgery
The key benefits of Laparoscopic Surgery in children include less pain, less cut/small incisions that look aesthetically better, less blood loss, less risk of infection, lesser hospitalisation (parents can go back to work sooner), faster recovery, early return to school, less risk of pneumonia and lesser chances of development of adhesive bowel obstruction.
Paediatric Minimally Invasive Surgeries are commonly performed for Hernia repair, Appendicectomy, Undescended testis, Pyeloplasty and Nephrectomy, Pull through surgery for Hirschsprung’s disease and anorectal malformation, Cholecystectomy and Choledochal cyst, Diaphragmatic Hernia Repair and Empyema surgery, Fundoplication, Pyloromyotomy, Malrotation, Abdominal cyst, Ovarian cyst, Mesenteric, and other cysts.
Is there any difference between Children and Adult’s Laparoscopic Procedures?
- Many surgical conditions in children are totally different from adults
- The laparoscopic hand instruments in children consists of smaller length and diameter
- In children, the inside space to work is less which makes surgery very difficult
- Minimally Invasive surgical team needs to be highly experienced and trained