The role of laparoscopic surgery in children

Although laparoscopy was widely evaluated by Drs Stephen Gans and George Berci in the 1970's, it did not become a useful clinical modality in paediatric surgery until relatively recently. It was reported by these workers to be a useful diagnostic modality, but as a therapeutic tool, its role was limited to simple biopsies. The introduction of computed tomography (CT) scan abdominal ultrasound imaging also limited its clinical application, as these modalities allowed very accurate diagnosis of clinical pathology without resorting to laparoscopy for diagnosis. Recently, the widespread acceptance of laparoscopic surgery in adult surgical practice has lead many centres including ours to evaluate the role of laparoscopic surgery in paediatrics. Although it will be some time before its benefits or otherwise in paediatrics are established, there is no doubt that laparoscopic surgery is safe in children in the hands of the skilled laparoscopist. There is also no doubt that the paediatric surgeon in future will have to be skilled in laparoscopic surgery as increasing demands are made on us to treat common surgical conditions without causing the patient physical harm. This paper reviews some of the common conditions being treated by the laparoscopic route in our institution and attempts to evaluate the early results.