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Laparoscopic Anterior Right Hepatectomy: A Single-Center Experience
Published on: December 4, 2023
Response to "Outcomes of infants undergoing laparoscopic pyeloplasty: A single-center experience"
Jorge Panach-Navarrete1, Lorena Valls-González1, José María Martínez Jabaloyas1
1Department of Urology, University Clinic Hospital of Valencia, Facultat de Medicina i Odontologia, Universitat de València, Valencia, Spain.
Insights
Laparoscopic pyeloplasty in infants is safe and effective, offering benefits like smaller scars and better visualization compared to open surgery. This minimally invasive approach is reproducible for experienced pediatric surgeons.
Area of Science:
- Pediatric Urology
- Minimally Invasive Surgery
Background:
- Concerns exist regarding complication rates of laparoscopic pyeloplasty in infants, as highlighted by studies like Erol et al.
- Meta-analyses support the safety and efficacy of the laparoscopic approach for pyeloplasty in pediatric patients.
Discussion:
- Laparoscopic pyeloplasty offers advantages over open surgery, including enhanced visualization of polar vessels and less invasive dissection of periureteral tissues.
- The smaller incisions (3-5 mm ports) in laparoscopic procedures are inherently smaller than those in open surgery.
Key Insights:
- Laparoscopic pyeloplasty demonstrates safety and positive outcomes in infants.
- Experienced pediatric surgeons can confidently perform this procedure due to its reproducibility.
Outlook:
- Further research and adoption of minimally invasive techniques like laparoscopic pyeloplasty are encouraged in pediatric urology.
- Studies contributing to the evidence base for laparoscopic pyeloplasty aid in expanding its use.
Abstract:
Although studies such as that of Erol et al. can raise doubts to a pediatric urologist about whether or not to carry out a laparoscopic approach in a pyeloplasty in infants, especially due to the percentage of complications, meta-analyses such as the one mentioned reinforce the safety and good results of the laparoscopic approach in these patients. The laparoscopic approach provides potential benefits over open surgery, such as better visualization of polar vessels, less aggressive dissection of periureteral tissues, or smaller scars. Although many open pyeloplasty incisions can be made small, they will never be smaller than those with 3 or 5 mm ports. Thus, any urologist or pediatric surgeon with experience in laparoscopic surgery has sufficient data at their disposal to be confident in the reproducibility and safety of laparoscopic surgery for pyeloplasties in infants. It is appreciated that works such as that of Erol et al. help minimally invasive techniques expand within pediatric urology.
