Laparoscopy and thoracoscopy

Abstract

Endoscopic surgery, including laparoscopic and thoracoscopic surgery, in children has become widespread in the past few decades due to its minimal invasiveness and better cosmetic results. However, it requires specific expertise and skills that are different from conventional open procedures. Surgeons have to fully understand the basics of endoscopic surgery, such as the lack of three-dimensional information, faint tactile sensation, and restricted movement of surgical devices; in such cases, numerous physiological pneumoperitoneum/pneumothorax effects appear in the patient. In addition, surgeons are required to be proficient in the endoscopic surgical skills acquired through extensive training using box trainers, virtual reality simulators, or animal surgery prior to clinical cases. With regard to pediatric endoscopic surgery, the organs of children are more fragile and the working space is smaller than in adult endoscopic surgery. Therefore, smaller devices and special considerations are needed when performing such procedures in children, particularly among neonates and infants. Moreover, collaboration with a pediatric anesthesiologist is vital for safe and secure procedures.