chapter  23
14 Pages

Laparoscopic paediatric urology

ByImran Mushtaq

The benefits of laparoscopic surgery to children are well known and include reduced postoperative pain, increased postoperative comfort, reduced hospital stay, quicker return to normal activities, improved cosmesis and reduced wound complications. Although very few randomised controlled studies have been performed to demonstrate these advantages, there is sufficient evidence in the literature to support the philosophy of minimally invasive surgery. The relatively smaller size of the

paediatric patient provides the surgeon with the unique advantage of being able to access both the upper (kidney) and lower (ureter) urinary tract through the same port sites. This advantage applies to both the transperitoneal and retroperitoneoscopic approaches, although the purists would prefer the transperitoneal route for access to the very distal ureter. Laparoscopy also provides superior access to the pelvis when dealing with müllerian duct remnants, intra-abdominal testes and cloacal anomalies as examples.