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Advances and Trends in Pediatric Minimally Invasive Surgery
Andreas Meinzer1, Ibrahim Alkatout2, Thomas Franz Krebs3
1Department of General Visceral, Thoracic, Transplant and Pediatric Surgery, UKSH University Hospital of Schleswig-Holstein Kiel Campus, Arnold-Heller-Strasse 3, 24105 Kiel, Germany.
Insights
Pediatric minimally invasive surgery is advancing with new techniques like robotic surgery and artificial uteruses. Future developments require rigorous trials to confirm improved surgical outcomes for children.
Area of Science:
- Pediatric Surgery
- Surgical Innovation
- Minimally Invasive Procedures
Background:
- Numerous meta-analyses exist comparing pediatric minimally invasive surgery (MIS) to open surgery.
- The field of pediatric MIS is broad, encompassing fetal, neonatal, and adolescent procedures.
Purpose of the Study:
- To review the current status of pediatric MIS.
- To identify future trends and developments in pediatric MIS.
Main Methods:
- Systematic search of print and electronic databases for relevant keywords.
- Cross-link searches of existing literature references.
- Independent application of eligibility criteria to full-text articles.
Main Results:
- Pediatric MIS includes fetal surgery, microlaparoscopy, and robotic surgery.
- Emerging technologies include natural orifice transluminal endoscopic surgery (NOTES), single-incision endoscopic surgery, and artificial uteruses.
- These innovations aim to reduce invasiveness in pediatric surgical procedures.
Conclusions:
- Technological advancements are poised to transform pediatric surgical practices.
- Prospective randomized controlled trials are essential to validate the efficacy of new MIS techniques and devices.
- Evidence-based validation is crucial to ensure improved surgical outcomes for pediatric patients.
Abstract:
As many meta-analyses comparing pediatric minimally invasive to open surgery can be found in the literature, the aim of this review is to summarize the current state of minimally invasive pediatric surgery and specifically focus on the trends and developments which we expect in the upcoming years. Print and electronic databases were systematically searched for specific keywords, and cross-link searches with references found in the literature were added. Full-text articles were obtained, and eligibility criteria were applied independently. Pediatric minimally invasive surgery is a wide field, ranging from minimally invasive fetal surgery over microlaparoscopy in newborns to robotic surgery in adolescents. New techniques and devices, like natural orifice transluminal endoscopic surgery (NOTES), single-incision and endoscopic surgery, as well as the artificial uterus as a backup for surgery in preterm fetuses, all contribute to the development of less invasive procedures for children. In spite of all promising technical developments which will definitely change the way pediatric surgeons will perform minimally invasive procedures in the upcoming years, one must bear in mind that only hard data of prospective randomized controlled and double-blind trials can validate whether these techniques and devices really improve the surgical outcome of our patients.
