Update on the Minimally Invasive Approach in Paediatric Urology: Remote Help for Human Hands?

The innovations of minimally-invasive surgery have successfully been applied to pediatric surgery. Some special caveats apply to children, however. Confinements of space and the small intravsacular blood volume pose special risks in small infants. Unlike in adults, placement of the first troikar should always be under direct vision. There is no consensus whether minimally-invasive approaches should be used in children under one year of age.Single-port approaches have also been used in children and for renal surgery both the transabdominal and the retroperitoneosocopic approach are feasible. Pneumovesicoscopy has successfully been used for ureteral reimplantation and robotic-assisted surgery for children has also been established. The cost-effectiveness of many techniques remains an unsolved problem.