Laparoscopy in children explained: What every parent should know about this surgical technique

Minimally invasive procedures like Laparoscopic surgery contribute to better emotional well-being and lower the risk of post-traumatic stress disorder (PTSD) following surgery (Image: Canva)

Pediatric laparoscopy, often called keyhole surgery, has changed  surgical care for children. It allows surgeons to diagnose and treat conditions like appendicitis, ovarian cysts, torsion of the ovary, and undescended testis with minimal invasion.

Unlike traditional open surgery, laparoscopy offers smaller scars, reduced pain, faster recovery, and a shorter hospital stay, says Dr Astha Dayal, Director of Obstetrics and Gynaecology, CK Birla Hospital, Gurgaon. “Apart from the physical benefits, a smaller scar reduces the chances of body image concerns in young children, while faster recovery and minimal pain help reduce stress for both the child and their parents,” she says.

According to the Journal of Pediatric Surgery, minimally invasive procedures also contribute to better emotional well-being and lower the risk of post-traumatic stress disorder (PTSD) following surgery. “However, despite its advantages, pediatric laparoscopy presents unique challenges due to anatomical and physiological differences from adults,” says Dr Dayal.

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Performing laparoscopic surgery on children is more complex than on adults due to differences in body structure, explains Dr Dayal. “Young girls have a lower height, thinner abdominal walls, a smaller uterus, and higher ovary positioning, which limits the working space for surgeons. These anatomical variations make it difficult to maneuver surgical instruments, requiring specialised expertise and equipment,” she says, adding that in newborns, the blood vessels near the navel are still developing and can be punctured if instruments are inserted incorrectly. “Also, older children, though more physically developed, have thinner abdominal walls, increasing the risk of bowel or vessel injuries. To reduce complications such as hernias, surgeons opt for the smallest possible instruments,” she says.

Administering anesthesia is another major challenge. "Children often resist IV medications, so inhalational agents are preferred for induction. Plus, pediatric patients experience greater fluctuations in blood pressure and heart rate during surgery compared to adults, requiring constant monitoring and careful fluid management,” says Dr Dayal.

According to the Journal of Pediatric and Adolescent Gynecology, physiological responses of children to surgery necessitate specialised anesthetic techniques to ensure safety. “Beyond the medical aspects, the psychological impact of surgery on young patients is another important consideration. Anxiety before surgery is common, not just for children but also for their parents,” says Dr Dayal. She adds that involving parents in the preoperative process and providing age-appropriate explanations can help reduce stress and improve the surgical experience.

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Solutions to overcome challenges

Despite these challenges, advancements in technology and surgical techniques have made pediatric laparoscopy safer and more effective. A research published in the Journal of Surgical Education highlights that advanced training in pediatric laparoscopy has significantly reduced complications and improved surgical precision, says Dr Dayal. “According to the Surgical Innovation journal using smaller instruments and high-definition cameras has helped surgeons overcome the difficulties of limited working space in pediatric surgery. These tools allow for better visualisation and more precise movements, making surgery more effective,” she adds.

Moreover, the Journal of Pediatric and Adolescent Gynecology suggests the importance of a multidisciplinary approach, where surgeons, anesthesiologists, and pediatricians work together to provide the best possible care. “This collaborative effort ensures that all aspects of a child's health—both physical and emotional, are addressed during surgery,” she says.

Future of pediatric laparoscopy:

Pediatric laparoscopy is becoming the preferred surgical technique for children, offering numerous advantages over open surgery. “As technology and training continue to evolve, this minimally invasive approach will only become safer and more effective. While it requires specialized expertise and careful patient management, laparoscopy ensures better outcomes, less pain, and a quicker return to normal life for children.” concludes Dr Dayal.

Disclaimer: This article, including health and fitness advice, only provides generic information. Don’t treat it as a substitute for qualified medical opinion. Always consult a specialist for specific health diagnosis.