الفهرس 
ANATOMICAL CONSIDERATIONSOnly 14 pages are availabe for public view
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Abstract
The first case of laparoscopy in pediatric surgery was reported by Stephen Gans in 1971, in his landmark publication, “Advances in Endoscopy of Infants and Children,” as a peritoneoscopy. The term peritoneoscopy was soon replaced by Pediatric Laparoscopy.
The availability of smaller instruments expanded the role and applications of laparoscopy in very small infants and newborns. Initially, application of laparoscopy in children was for diagnostic purposes.
Laparoscopic surgery is becoming the standard of care for many pediatric conditions. There is an increased demand from referring physicians as well as the public for laparoscopic minimally invasive surgery. It is the responsibility of surgeons to insure that these procedures are as safe as possible for their patients. Careful preparation and training are the cornerstones of successful outcomes The possibility of converting to an open procedure should always be explained to the parents and patient and informed consent should be obtained. There are many new and advanced laparoscopic procedures in pediatric surgery, some still controversial. As new procedures are implemented, we will need to learn more about their potential complications and how to avoid them. Rapid recognition of complications and the appropriate treatment of these problems can minimize their impact.
laparoscopic pediatric surgeons perform procedures like impalpable undescended testis, congenital inguinal hernia, appendectomy and many others.
Anatomical and physiological differences in children may require a modification of the techniques used in adults.
Anatomical considerations in the pediatric patient are related to the variation in size and the stage of development.
Physiological changes secondary to insufflation of the abdomen or the chest are generally well tolerated in the adult patient but can present a challenge to the anesthesiologist in the pediatric patient.
There are complications specifically related to the minimally invasive approach and complications of the actual procedure. Problems secondary to the laparoscopic/thoracoscopic approach may be physiologic disturbances due to insufflation, access, or equipment .
The incidence of complications in pediatric laparoscopy is reported to be around 4-5%.In most cases the complication can be managed laparoscopically. A conversion rate of 5-10% has been reported as acceptable.. Complications that are procedure specific may occur with an open technique as well as a minimally invasive approach. Laparoscopy cause less tissue trauma and, theoretically, less postoperative pain than open surgery.