Robotic Surgery may Not “Make the Cut” in Pediatrics

Since the introduction of robotic surgery in children in 2001, it has been employed by select pediatric laparoscopic surgeons but not to the degree of adult surgical specialists. It has been suggested that the technical capabilities of the robot may be ideal for complex pediatric surgical cases that require intricate dissection. However, due to the size constraints of the robot for small pediatric patients, the tight financial margins that pediatric hospitals face, and the lack of high level data displaying patient benefit when compared to conventional laparoscopic surgery, it may be some time before the robotic surgical platform is widely embraced in pediatric surgical practice

Use of operative laparoscopes in single-port surgery: The forgotten tool

Single-port surgery is an emerging advancement in the field of minimally invasive surgery. Several different techniques and tools have been developed to decrease the invasiveness of various operations. Amongst these new developments, many general surgeons have overlooked an important tool, the operative laparoscope. These telescopes reduce the number of ports placed during minimally invasive operations by providing both visualization and operative channels to accommodate instruments. We have described several simple techniques that employ the operative laparoscope to reduce the number of incisions in laparoscopic surgery with good outcomes. Single-port surgery has been shown to be safe and effective and may someday replace traditional laparoscopy in the performance of minimally invasive operations

Single-port laparoscopy: Considerations in children

As the quest to minimize scars from surgery continues, innovative methods of surgery, including single-port surgery, have come to the forefront. Here, we review considerations for surgery in children with particular attention to appendectomy and cholecystectomy. We discuss the future technologies that will aid in single-port surgery and how they apply to the paediatric population

Surgical therapy for biliary dyskinesia: A meta-analysis and review of the literature

Background: Although biliary dyskinesia is treated commonly with cholecystectomy, the supporting literature is limited. A review and meta-analysis of the literature were performed to assess the efficacy of surgical therapy for biliary dyskinesia. Materials and Methods: A MEDLINE search for the period 1965 to 2003, using the search strings biliary, acalculous, dyskinesia, cholecystitis, cholecystectomy, and therapy returned 187 articles. Inclusion criteria required a study design that placed patients with biliary dyskinesia into one of two treatment groups, cholecystectomy or nonoperative therapy, and a follow-up assessment of symptomatic improvement. Results: Five studies met the inclusion criteria, representing a total of 274 patients. Surgical therapy resulted in 98% symptomatic relief compared to 32% with nonoperative management (P \u3c 0.0001). Patients undergoing surgical therapy for biliary dyskinesia were 2.79 times more likely to have symptomatic relief versus nonoperative therapy (95% confidence interval, 2.05-3.79). Conclusion: Based on this meta-analysis, cholecystectomy for biliary dyskinesia is an effective therapy and offers significant symptomatic relief over nonoperative therapy. © Mary Ann Liebert, Inc