Laparoscopic Surgery in Children; Early Experience

Eom, Sang Yil; Lee, Ju Hyun; Park, Jong Hoon; Rhee, Jung Ahn; Kim, Sang Youn

Abstract

PURPOSE: The application of laparoscopic surgery in children has expanded tremendously in recent years. However, the feasibility of the technique is somewhat controversial. We summarize our experience of laparoscopy in children and describe the surgical techniques used in these cases.
METHODS
Between June 2001 and May 2004, 58 children (33 male, 25 female) underwent laparoscopic surgery at the Department of Surgery, Daegu Fatima hospital. All the clinical data was collected retrospectively.
RESULTS
The laparoscopic procedures for each indications were a laparoscopic reduction for a barium reduction failed intussuception (n=15), laparoscopic appendectomy for acute appendicitis (n=30), laparoscopic splenectomy for symptomatic hereditary spherocytosis (n=4), laparoscopic salphin-go-ophorectomy for torsion of parovarian cyst and ovarian tumor (n=2), laparoscopic diverticulectomy for symptomatic Meckel's diverticulum (n=2), laparoscopic Hellor myotomy and Dor fundoplication for achalasia (n=1), diagnostic purpose for peritoneal tuberculosis (n=2) and the laparoscopic removal of a foreign body in the peritoneal cavity (n=2). The mean age was 7.9 years (range from 4 months to 14 years). In intussusception, the laparoscopic reduction was successful in 12 patients (80%), with a conversion to an open procedure occurring in 3 cases (20%). There were no other open con-versions. There were no postoperative wound complications except for two wound problems in patients with acute perforated appendicitis. The operative time and duration of the hospital stay was suitable.
CONCLUSION
The laparoscopic procedure in various disorders of infants and children is safe and avoids the necessity of open surgery under the appropriate indication.