Minimally invasive surgery for pediatric trauma-a multicenter review

Area of Science:

• Pediatric Surgery
• Trauma Surgery
• Minimally Invasive Surgery

Background:

• Published experience with minimally invasive surgery (MIS) in pediatric trauma is limited.
• This multicenter case series characterizes the contemporary role of MIS in treating injured children.

Purpose of the Study:

• To evaluate the safety and efficacy of minimally invasive surgical techniques in pediatric trauma patients.
• To characterize the contemporary role of laparoscopy and thoracoscopy in managing pediatric trauma.

Main Methods:

• Retrospective review of 200 pediatric patients undergoing thoracoscopy or laparoscopy for trauma over 13 years.
• Data collected from six pediatric trauma centers in the United States.
• Analysis of procedure types, conversion rates, operative times, and outcomes.

Main Results:

• 205 MIS procedures performed (94% laparoscopic).
• 36% conversion rate to open surgery, most common for bowel injury.
• Effective for diagnostic (61%) and therapeutic interventions (bowel repair, splenectomy, hemothorax evacuation).
• Low rates of complications (19 patients), long-term sequelae (10 patients), and permanent disability (2 patients). No deaths or missed injuries.

Conclusions:

• Laparoscopy and thoracoscopy are safe and effective for pediatric trauma patients.
• MIS can be utilized for both diagnostic and therapeutic purposes in stable pediatric trauma cases.
• Minimally invasive approaches offer favorable outcomes with minimal complications.