Thoracoscopy in pediatrics: Surgical perspectives

Area of Science:

• Pediatric Surgery
• Minimally Invasive Surgery
• Thoracoscopy

Background:

• Minimally invasive surgery, including thoracoscopy, has advanced significantly in pediatric disciplines over the past decade.
• Improved instruments and magnification enable thoracoscopic application in neonates and infants.
• Thoracoscopy is increasingly the preferred surgical method over thoracotomy for pediatric conditions.

Purpose of the Study:

• To review the unique aspects of thoracoscopic surgery in children.
• To identify technical and anatomical challenges specific to pediatric thoracoscopy.
• To present proposed solutions for these challenges.

Main Methods:

• Literature search of recent publications using keywords: thoracoscopy, pediatric, lung biopsy, decortication, lobectomy, mediastinum, esophagus, diaphragmatic hernia.
• Review of established and emerging thoracoscopic techniques in pediatric surgery.

Main Results:

• Thoracoscopy demonstrates satisfactory outcomes in pediatric pulmonary resections, mediastinal tumor biopsy/resection, diaphragmatic hernia repair, decortication, and tracheoesophageal fistula repair.
• Technique modifications are essential for successful thoracoscopy in pediatric patients due to anatomical differences from adults.

Conclusions:

• Thoracoscopic surgery is a safe and effective approach for various pediatric thoracic conditions.
• Training in pediatric thoracoscopy is becoming integral to surgical residency programs worldwide.
• Addressing unique pediatric anatomical and technical challenges is key to optimizing thoracoscopic outcomes.