Minimally invasive surgery in paediatrics

One of the main reasons for slow acceptance of minimally invasive surgery in paediatrics has been the lack of availability of appropriate instruments and equipment. Insufflators with very slow flow rates (0.1 l/m) and low pressures (6 8 mmHg), instruments with smaller diameter (2 3 mm) and short length (20 cm) had to become commercially available. Today instruments ranging from needle holders to dissectors and scissors are made in sizes that allow surgeons to operate on 1 000 g premature babies using MIS. Anaesthetic challenges also are better understood and safe surgery can be performed. Use of a digital theatre environment with improved ergonomics has resulted in faster turnover times with increased surgery.