ABSTRACT
References 133
Pediatric surgical experience in minimal access hepatobiliary and pancreatic surgery has
been limited. This is partly due to the generally advanced laparoscopic skills necessary to
undertake many of the operations, a factor that will be remedied as pediatric surgeons gain
expertise in these techniques. A second factor is the limitations in instrumentation that
most pediatric centers are faced with. The complexity of the hepatobiliary and pancreatic
anatomy, together with the relatively small working space in children, requires smaller
instrumentation and more advanced technology that may be unavailable to the pediatric
surgeon. It is likely that tools, such as the surgical robot, will greatly increase the facility
with which minimal access hepatobiliary surgery can be performed. Furthermore, the
development of radiologically guided procedures as an alternate form of minimal
access surgery may obviate the need to perform some laparoscopic procedures.
