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[Endoscopic surgery in children: current status and problems]
Yasuhide Morikawa1, Ken Hoshino, Masaki Kitajima
1Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
Insights
Pediatric endoscopic surgery has advanced significantly over the last decade, offering minimally invasive options for various childhood conditions. Efficient training systems are crucial to maintain expertise due to the limited patient numbers and diverse pathologies in pediatric endosurgery.
Area of Science:
- Pediatric surgery
- Minimally invasive surgery
- Endoscopic techniques
Context:
- Endoscopic surgery has been established in pediatric and infant surgical care over the past decade.
- Pioneering work by pediatric endosurgery specialists has led to its widespread adoption.
- Procedures include pull-through for Hirschsprung's disease and anorectal malformations, pyloromyotomy, and hernia repair.
Purpose:
- To review the established applications and advancements in pediatric endoscopic surgery.
- To highlight the current scope of endoscopic procedures in treating pediatric surgical conditions.
- To identify the need for improved training systems in pediatric endosurgery.
Summary:
- Endoscopic surgery is now a standard treatment for conditions like Hirschsprung's disease (laparoscopic pull-through).
- It is utilized for malignancies, malrotation, intussusception, and advanced procedures like esophageal atresia repair.
- The field requires efficient training systems to address the challenges of small patient volumes and diverse pediatric pathologies.
Impact:
- Established minimally invasive surgical options for a range of pediatric conditions.
- Demonstrates the successful application of advanced endoscopic techniques in infants and children.
- Underscores the necessity for specialized training to ensure proficiency in pediatric endosurgery.
Abstract:
Endoscopic surgery has been established in various surgical conditions in children and infants for the past 10 years after pioneering work by experts specializing in pediatric endosurgery. These include pull-through for Hirschsprung's disease and anorectal malformations, pyloromyotomy, hernia repair, and endoscopic surgery for malignancies, malrotation, intussusception, etc. Laparoscopic pull-through is now accepted as a standard modality for the treatment of Hirschsprung's disease. Advanced endoscopic procedures such as esophageal atresia repair or fetal tracheal occlusion have also been performed. An efficient system for training is needed to compensate for the small number of patients and varieties of specific illness in children.