oa Laparoscopy in pediatric emergencies

Aims: Although laparoscopy is rapidly becoming the procedure of choice in adults, there are obstacles to its use in children. We analyzed our institution's experiences with laparoscopic procedures performed in children over the last 5 years, with particular emphasis on emergency procedures. Methods: We retrospectively evaluated the records of patients less than 14 years of age who had undergone laparoscopy for non-trauma related emergency conditions between January 2006 and December 2010 in our institution. Clinical parameters evaluated included operation time, total length of hospital stay, and postoperative complications. Results: Over the study period, children less than 14 years old underwent 482 laparoscopic procedures, 300 on an emergency basis and 182 electively. The majority of procedures were laparoscopic appendectomies, with most of the others being resections of ovarian cysts, Meckel's diverticula, or adhesiolyses. We observed improvement in outcomes over the 5-year period, as shown by decreased operation times and shorter postoperative hospital stays. Moreover, the numbers of laparoscopically performed procedures increased over time. Conclusion: Laparoscopy provides excellent results, including better exposure and cosmetic outcomes, when used for emergency operations in children. In our institution, the numbers and types of laparoscopic procedures have increased over time, and their outcomes have improved.