Our Summary

This research paper investigates whether laparoscopic surgery (a minimal invasive surgery using small incisions and a camera) is more effective than traditional open surgery for children. The authors reviewed hundreds of studies involving over 900,000 patients who underwent 19 types of procedures. They found that in most cases, laparoscopic surgery led to shorter hospital stays, and fewer mild to moderate complications. However, laparoscopic surgery often took longer to perform than open surgery. For some specific procedures, such as a type of surgery for liver disease, laparoscopic surgery was linked to more severe complications. They also noted that over time, more studies have reported disadvantages of laparoscopic surgery. The authors conclude that laparoscopic surgery seems to be beneficial for most types of procedures in children, but they also highlight the need for more high-quality studies to confirm these findings.

FAQs

  1. Does laparoscopic surgery result in shorter hospital stays and fewer complications than traditional open surgery in children?
  2. What are the disadvantages of laparoscopic surgery as reported in recent studies?
  3. Are there certain types of procedures where laparoscopic surgery may lead to more severe complications in children?

Doctor’s Tip

One helpful tip a doctor might tell a patient about laparoscopic surgery is to follow all pre-operative instructions carefully, such as fasting before the procedure and stopping certain medications as directed. This can help reduce the risk of complications during and after the surgery. Additionally, it is important to discuss any concerns or questions with the surgeon beforehand to ensure a successful outcome. Finally, following post-operative care instructions, such as proper wound care and activity restrictions, can help promote a smooth recovery process.

Suitable For

Patients who are typically recommended for laparoscopic surgery include those who require procedures such as cholecystectomy (gallbladder removal), appendectomy (appendix removal), hernia repair, gastric bypass surgery, and certain gynecological surgeries. These patients may benefit from the minimally invasive nature of laparoscopic surgery, which can result in less pain, quicker recovery time, and reduced risk of complications compared to traditional open surgery. Additionally, patients who are at higher risk for complications from open surgery, such as older adults or those with underlying health conditions, may also be good candidates for laparoscopic surgery.

Timeline

Before laparoscopic surgery:

  1. Patient consults with a surgeon to discuss the procedure and potential risks and benefits.
  2. Patient undergoes preoperative testing and evaluation to ensure they are a suitable candidate for laparoscopic surgery.
  3. Patient may need to make lifestyle changes or take medications in preparation for surgery.
  4. Patient is instructed on fasting guidelines prior to surgery.

During laparoscopic surgery:

  1. Patient is administered anesthesia and positioned on the operating table.
  2. Surgeon makes small incisions in the abdomen and inserts a camera and specialized instruments to perform the procedure.
  3. Surgeon visualizes the internal organs on a monitor and performs the necessary surgical steps.
  4. Surgery may take longer than open surgery due to the precision required in laparoscopic procedures.
  5. After completing the surgery, the incisions are closed with sutures or adhesive strips.

After laparoscopic surgery:

  1. Patient is monitored in the recovery room for any immediate complications.
  2. Patient may experience pain and discomfort at the incision sites, which can be managed with pain medication.
  3. Patient is advised on postoperative care, including wound care, activity restrictions, and follow-up appointments.
  4. Patient may need to gradually resume normal activities and diet as directed by their healthcare provider.
  5. Patient follows up with the surgeon for a postoperative evaluation to ensure proper healing and recovery.

What to Ask Your Doctor

  1. What are the potential benefits of laparoscopic surgery compared to traditional open surgery for my specific condition?
  2. What are the potential risks or complications associated with laparoscopic surgery?
  3. How long will the laparoscopic surgery take compared to open surgery?
  4. Will I have a shorter hospital stay with laparoscopic surgery?
  5. Are there any specific factors about my condition that may make me a better candidate for laparoscopic surgery?
  6. What is the recovery process like after laparoscopic surgery?
  7. Are there any long-term effects or considerations to keep in mind with laparoscopic surgery?
  8. How many of these procedures have you performed, and what is your success rate with laparoscopic surgery?
  9. Are there any alternative treatment options to consider besides laparoscopic surgery?
  10. Are there any specific precautions or steps I should take before undergoing laparoscopic surgery?

Reference

Authors: Kiblawi R, Zoeller C, Zanini A, Kuebler JF, Dingemann C, Ure B, Schukfeh N. Journal: Eur J Pediatr Surg. 2022 Feb;32(1):9-25. doi: 10.1055/s-0041-1739418. Epub 2021 Dec 21. PMID: 34933374