UroToday - This study from Boston Children's Hospital defined the incidence and risk factors for complications in children undergoing laparoscopic pediatric urologic surgery. They retrospectively reviewed all of their laparoscopic and robotic assisted cases between 1995-2005. They reviewed a total of 806 laparoscopic procedures and found an overall complication rate of 2%. They found that Veress needles caused the majority of access related injuries. 2.3% of the cases had access injuries caused by a Veress needle, while only 0.8% had access injuries when utilizing an open technique. There was a 0.4% rate of vessel injury, as well as a 0.4% rate of bowel injury.

Bleeding from vessel injuries requiring open conversion occurred 0.1% of the time. The bladder perforation rate was 0.1%, and the vas deferens injury rate was 0.2%. They also found that surgeons who performed more than 12 laparoscopic cases per year had significantly lower complication rates.

The group concluded that the low risk of complications proves that laparoscopic procedures are safe in the pediatric group. Nonetheless, they feel there is a significant enough risk to warrant the appropriate consent. They stress that proper adherence to technique and ongoing education can help improve complication rates, if not completely prevent them.

Passerotti CC, Nguyen HT, Retik AB, Peters CA.
Volume 180, Issue 2, Pages 681-685
doi:10.1016/j.juro.2008.04.042

Reported by UroToday Medical Editor Pasquale Casale, MD

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