Reconstructive laparoscopy in pediatric urology

Minimally invasive surgery used to play a role only as a diagnostic tool in pediatric urology, being used in a narrow range of conditions like cryptorchidism. With the breakthrough of laparoscopic techniques, skilled surgeons and remarkably the advances in robotic-assisted surgery, laparoscopy has gained a role for treatment purposes in pediatric urology.

Many reconstructive laparoscopic procedures notably with the aid of robotic-assisted surgery such as pyeloplasty and ureteral reimplantation and even more challenging procedures like appendicovesicostomy became feasible with similar results to those with open surgery. Even though minimally invasive approaches may have the drawback of greater technical difficulty, they have the advantages of shorter hospital stays, lesser postoperative pain and better cosmesis.

There is still a lack of controlled prospective randomized trials assessing the differences between open and minimally invasive techniques for reconstructive pediatric urology. Nevertheless, the minimally invasive approach has proven itself to be feasible and well tolerated for most reconstructive procedures.