[Intraoperative endoscopy in pediatric surgery: indications and results]

Intraoperative endoscopy in pediatric surgery was first performed in Germany at the begining of 1972. This method is an optical support for the surgeon to recognize pathological-anatomical alterations by the effect of the diaphanoscopy. It concerns primarily the upper and lower gastrointestinal systems as well as the tracheobronchial system. The endoscope can be placed intraoperative at the predetermined morphological alteration level enabling the surgeon to perform the surgical procedure at that special circumscrip area. This avoids local intensive trauma and protects nerve fibers, blood supply and other organs. Main indications are H-fistulae, tracheal stenosis, esophageal diverticula and perforations, gastroesophageal reflux, gastrointestinal bleeding and supralevator anorectal anomalies. Between 1984 and 1995 we have performed an intraoperative endoscopy in 310 children between the age of one day and 16 years. In a high percent of the explorations the identification of the preoperative findings were confirmed. Advantages of this method are less intraoperative complications concerning bleeding, organic and neurological lesions and a faster functional recovery of the organ due to an atraumatic procedure.