The scope of paediatric laparoscopy

Minimal access techniques have revolutionised surgery in the past twenty years. The concept originated in the early twentieth century and has now become part of standard surgical practice.The potential benefits of laparoscopy include reduced pain, functional impairment and inpatient stay and improved cosmesis. Recent technological advances have assisted in the application of the techniques to a paediatric population. There are now few paediatric surgical procedures remaining that have not been performed using minimal access techniques. The scope of laparoscopy in paediatric surgery encompasses neonatal surgery, thoracic surgery, gastrointestinal surgery, oncology and urology.The evidence base for laparoscopic over open surgery in childhood remains small but is growing. Laparoscopic surgery has been demonstrated to be at least equivalent to its open counterpart in some procedures and superior in a few.Recent advances in paediatric laparoscopy have largely concentrated on reducing the size of incisions needed to operate. This trend seems likely to continue with the introduction of natural orifice transluminal endoscopic surgery and the blurring of distinctions between surgeons, endoscopists and interventional radiologists.