Laparoscopic Surgery for Children
Laparoscopic surgery has several advantages over conventional surgery for the patient. An increasing number of diagnostic and surgical procedures are being done laparoscopic not only in adults but also in paediatrics patients. In addition to the routine anaesthetic considerations for any surgical patient, the choice of the anaesthetic technique in patients undergoing laparoscopic procedures should consider the patient's underlying cardio respiratory functions induced by the pneumoperitoneum and carbon dioxide [CO2] insufflations.
Laparoscopic surgery, compared to conventional surgery, has many advantages for the patient, including smaller incisions, lesser postoperative pain, earlier oral intake, quicker mobilization, faster discharge and a better cosmetic effect.1,2 In recent years, there has been a considerable improvement in laparoscopic surgical techniques and equipments and this has led to an increasing number of diagnostic and surgical procedures being done laparoscopically not only in adults but also in paediatric patients. Ure and colleagues3 have reported a spectrum of 26 different surgical procedures being performed laparoscopically.
The common laparoscopically performed procedures in children include appendicectomy, pyloromyotomy, diagnosis of contralateral inguinal hernia, cholecystectomy, gastric fundoplication etc.3 Several other laparoscopic procedures have been reported in the paediatric population including liver biopsy, cholangiograms, splenectomy, colectomy, nephrectomy, and rectal pull-through.1,3,4 In addition to the routine anaesthetic considerations for the individual patient, the choice of the anaesthetic technique in these patients should consider changes in haemodynamic and respiratory functions induced by the pneumoperitoneum and carbon dioxide (CO2) insufflation.5 This article describes the physiological changes produced by laparoscopy in children and the anaesthetic considerations for laparoscopic procedures in the paediatric patient population.
Your healthcare provider has recommended laparoscopic urologic surgery for your child. This is to help diagnose or treat a problem in the urinary tract. Laparoscopic surgery uses smaller incisions than "open" surgery. This means your child is likely to have less pain and a faster recovery.
What are the benefits of laparoscopy?
Laparoscopy is a type of surgery that uses a long, thin, tube-like instrument with a camera and light (laparoscope). The scope allows the surgeon to see and operate inside the belly (abdomen). Small surgical instruments are also used. Laparoscopy often involves the following:
- A short hospital stay (your child may even be able to go home the same day)
- A faster recovery than with open surgery
- Smaller scars on the skin
- Less pain after the procedure
How do we prepare for the procedure?
Tell the surgeon about any medicines your child takes. Include herbs, supplements, and over-the-counter medicines. You may need to have your child stop taking certain medicines, such as ibuprofen, before the surgery.
Discuss with the surgeon any allergies and health problems your child has.
Follow any directions your child is given about eating and drinking before surgery. If you do not follow the instructions, the surgery may have to be postponed.
Meet with the child’s anesthesiologist before the surgery. He or she gives your child medicine so your child sleeps and does not feel pain during the surgery. The anesthesiologist also monitors your child’s heart rate, blood pressure, and oxygen levels during the procedure.