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Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
[Minimally invasive paediatric surgery in other than paediatric surgical departments]
B M Ure1, M L Metzelder, S Kellnar
1Kinderchirurgische Klinik, Medizinische Hochschule Hannover, Hannover. ure.benno@mh-hannover.de
Insights
Minimally invasive pediatric surgery offers benefits but requires specialized expertise. Its use outside dedicated pediatric centers needs further investigation to ensure safety and feasibility for complex procedures.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
Background:
- Minimally invasive techniques are widely adopted in pediatric surgery, demonstrating safety and benefits like improved recovery and cosmesis across all pediatric age groups.
- Established pediatric-specific procedures necessitate specialized surgical expertise beyond general surgical experience.
Purpose of the Study:
- To evaluate the current status and prerequisites for minimally invasive pediatric surgery outside of specialized pediatric surgical centers.
- To identify the necessary conditions for the safe and effective implementation of these techniques in non-specialized settings.
Main Methods:
- Review of established minimally invasive pediatric surgical procedures and their adoption in various departments.
- Analysis of the required expertise for surgeons and anesthesiologists in minimally invasive pediatric surgery.
- Assessment of the current limitations and data gaps regarding the use of these techniques in non-pediatric surgical centers.
Main Results:
- While minimally invasive surgery is established in pediatric departments, data on its use outside these centers is limited.
- Prerequisites for safe implementation include a high volume of pediatric specialty operations, surgeon expertise in minimally invasive techniques, and specialized anesthesiology support.
- Current assumptions for these prerequisites are mainly met by non-pediatric specialty operations, such as laparoscopic appendectomy.
Conclusions:
- Minimally invasive pediatric surgery should be restricted to departments with surgical volumes comparable to pediatric surgical centers.
- Adequate surgical and anesthesiology expertise is mandatory for the safe application of these techniques.
- Further research is required to investigate the feasibility and safety of minimally invasive techniques in specialty pediatric operations performed outside of dedicated pediatric surgical centers.
Abstract:
Minimally invasive techniques are well established in numerous paediatric surgical departments. They are safely applied to children of all age groups. Numerous types of procedures have been established specifically for children and, therefore, the necessary expertise cannot be derived from general surgical experience. Advantages in postoperative symptoms, convalescence and cosmesis have been confirmed. However, data or recommendations concerning the use outside of centres of paediatric surgery are lacking. In the opinion of the authors, minimally invasive paediatric surgery should only be considered for departments with a volume of paediatric specialty operations similar to that of paediatric surgical centres. In addition, an adequate number of operations, specific expertise of the surgeons in minimally invasive paediatric surgery, and specific expertise of anaesthesiologists is mandatory. Today, these prerequisites can only be assumed for non-paediatric specialty operations, such as laparoscopic appendectomy. In conclusion, before recommendations can be made for minimally invasive techniques in specialty paediatric operations outside of paediatric surgical centres, the feasibility and safety under these conditions has to be investigated.
