ABSTRACT
References 118
1. INTRODUCTION
Minimal access surgery (MAS) requires creation of a working space, the insertion of a
telescope for visualization and additional ports for therapeutic instrumentation. Since
the early 1990s, the number and variety of minimal access procedures performed by pedi-
atric surgeons has grown exponentially. More advanced procedures have become feasible
with the major advances in miniaturized video equipment and instrumentation. MAS is
now firmly established in the armamentarium of modern pediatric surgical practice. In
the United States, .80% of pediatric surgeons perform MAS (1). Enthusiasm for MAS must be tempered; however, by an appreciation for its compli-
cations and limitations. As Tam stated, MAS only provides an alternative method of per-
forming the same operation as open (1). No additional lives are saved. The benefits are
measured in terms of quality of life. Current literature details reports of minimal access
approaches to traditional open operations. Few procedures have been critically evaluated
in a prospective randomized controlled trial, but initial studies suggest better outcomes
secondary to reduced hospitalization and earlier return to normal activity.
