General principles of minimally invasive surgery in paediatric surgical oncology

Area of Science:

• Paediatric Surgical Oncology
• Minimally Invasive Surgery

Background:

• Minimally invasive surgery (MIS) is increasingly used in paediatric surgical oncology (PSO).
• Benefits include faster recovery, less pain, and improved cosmetic outcomes.
• Safe application requires strict adherence to oncological principles to prevent complications like tumor spillage or incomplete resection.

Purpose of the Study:

• To review general principles, indications, and contraindications for MIS in paediatric oncology.
• To highlight tumor- and histology-specific considerations for MIS application.
• To emphasize key factors for ensuring safety and efficacy in MIS for paediatric cancer.

Main Methods:

• Review of general principles, indications, and contraindications for MIS in paediatric oncology.
• Highlighting tumor- and histology-specific considerations.
• Emphasis on technical aspects, patient selection, and multidisciplinary coordination.

Main Results:

• Commonly accepted MIS applications include selected neuroblastoma, Wilms tumor (post-neoadjuvant therapy), lung metastasectomy, and resection of mediastinal, hepatic, and adnexal masses.
• Contraindications involve large/fragile tumors, high-risk neuroblastomas with vascular encasement, and insufficient surgeon experience or resources.
• Technical aspects, patient selection, and multidisciplinary coordination are crucial for safety and efficacy.

Conclusions:

• Establishing MIS guidelines in PSO is essential for surgeon decision-making.
• Guidelines promote consistent standards of care in paediatric surgical oncology.
• MIS can be safely and effectively applied in selected paediatric oncology cases when oncological principles are followed.