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Minimally-invasive pediatric surgery in 2004: a survey including 50 German institutions
Annika I Schmidt1, Carsten Engelmann, Holger Till
1Department of Pediatric Surgery, Medical University Hanover, 30625 Hannover, Germany.
Insights
Pediatric surgical departments in Germany increasingly use minimally invasive surgery. However, advanced laparoscopic and thoracoscopic procedures are still limited in many institutions.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Surgical Techniques
Background:
- Presents a survey on the current practice of laparoscopic and thoracoscopic surgery in German pediatric surgical departments.
- Highlights the adoption trends of minimally invasive surgical techniques in pediatric care.
Purpose of the Study:
- To assess the spectrum and frequency of minimally invasive operations performed in German pediatric surgical departments.
- To evaluate the adoption of advanced laparoscopic and thoracoscopic procedures.
- To understand the distribution of surgeons performing these procedures.
Main Methods:
- A questionnaire was distributed to all 71 pediatric surgical departments in Germany.
- Data collected primarily for the year 2004, including procedure types, quantities, conversions, complications, and surgeon numbers.
- Survey response rate of 70% (50 institutions).
Main Results:
- Laparoscopic techniques were utilized in 96% and thoracoscopic techniques in 74% of responding departments.
- Common procedures included appendectomy (90%), varicocelectomy (64%), and Fowler-Stephens operation (66%).
- Advanced procedures like laparoscopically assisted pull-through for Hirschsprung disease were offered by 42%, while highly complex surgeries were offered by only 20%.
Conclusions:
- Minimally invasive techniques are widely adopted in German pediatric surgical settings for various indications.
- A significant number of departments still have limited capacity for performing major, complex minimally invasive procedures.
Background:
A survey on the practice of laparoscopic and thoracoscopic surgery in pediatric surgical departments in Germany is presented.
Materials And Methods:
A questionnaire was sent to all 71 pediatric surgical departments in Germany (population 82 million). Fifty institutions (70%) took part in the survey that mainly included data for the year 2004: spectrum of minimally invasive operations, quantity of procedures, conversions, major complications, number of performing surgeons and residents.
Results:
Laparoscopic techniques were used in 48 departments (96%) and thoracoscopic techniques in 37 (74%). The annual frequency of laparoscopies was less than 100 in 30 departments (62%) and more than 100 in 15 (31%). The number of thoracoscopies was less than 50 in 35 departments (73%) and more than 50 in 2 (4%). Appendectomy was offered in 45 (90%), varicocelectomy in 32 (64%), and Fowler-Stephens operation in 33 (66%). Twenty-one departments (42%) covered more advanced procedures such as laparoscopically assisted pull-through for Hirschsprung disease. Most demanding procedures such as laparoscopic choledochal cyst resection, duodeno-duodenostomy, heminephrectomy, or pyeloplasty were offered by 10 departments (20%). Minimally invasive surgery was performed by 1 surgeon (12%) in 6 institutions and by more than 5 surgeons (14%) in 7 institutions.
Conclusion:
Minimally invasive techniques are increasingly accepted in most German pediatric surgical institutions for a wide range of indications. However, the number of departments offering major minimally invasive procedures remains limited.
