Laparoscopic surgery in children

Laparoscopic surgery in children is not new. Paediatric surgeons were among the pioneers of laparoscopic surgery in the early 1970s, but the vast potential of this “minimally invasive” approach to treat children with surgical conditions has only recently begun to be realised. For over two decades, paediatric laparoscopy was restricted mainly to diagnostic use. In the early 1990s, an explosive expansion of laparoscopic surgery occurred in adults as a result of the success of laparoscopic cholecystectomy. Nevertheless, interest in laparoscopic surgery in children remained confined to a few enthusiasts initially, while the rest of the paediatric surgical community adopted a “wait and see” attitude. More recently however, with increasing experience in paediatric laparoscopic procedures, and advances in miniaturised instrumentation, laparoscopy’s place in the modern paediatric surgical armamentarium has finally become accepted. In the USA, it is estimated that 82% of paediatric surgeons perform laparoscopic surgery. The question is no longer whether laparoscopic surgery should be done in children, but what conditions should be treated laparoscopically.