This article discusses the potential benefits and challenges of minimally invasive surgery for infants and small children, and discusses why pediatric minimally invasive surgery is not yet the surgical default or standard of care. Minimally invasive methods offer advantages such as smaller incisions, decreased risk of infection, greater surgical precision, decreased cost of care, reduced length of stay, and better clinical information. But none of these benefits comes without cost, and these costs, both monetary and risk-based, rise disproportionately with the declining size of the patient. In this review, we describe recent progress in minimally invasive surgery for infants and children. The evidence for the large benefits to the patient will be presented, as well as the considerable, sometimes surprising, mechanical and physiological challenges surgeons must manage.
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September 2012
State-of-the-Art Review Article|
Ethics Rounds|
September 01 2012
Pediatric Minimally Invasive Surgery: Laparoscopy and Thoracoscopy in Infants and Children
Thane Blinman, MD;
aChildren’s Hospital of Philadelphia, Philadelphia, Pennsylvania; and
Address correspondence to Thane Blinman, MD, Children’s Hospital of Philadelphia, 34th and Civic Center, Philadelphia, PA 19083. E-mail: blinman@email.chop.edu
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Todd Ponsky, MD
Todd Ponsky, MD
bCase Western Reserve University, Cleveland, Ohio
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Address correspondence to Thane Blinman, MD, Children’s Hospital of Philadelphia, 34th and Civic Center, Philadelphia, PA 19083. E-mail: blinman@email.chop.edu
FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.
Pediatrics (2012) 130 (3): 539–549.
Article history
Accepted:
April 20 2012
Citation
Thane Blinman, Todd Ponsky; Pediatric Minimally Invasive Surgery: Laparoscopy and Thoracoscopy in Infants and Children. Pediatrics September 2012; 130 (3): 539–549. 10.1542/peds.2011-2812
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