Pediatric Minimally Invasive Surgery Overview and FAQs
The pediatric urology program at Children’s Medical Center Dallas, the flagship hospital of Children’s Health℠, is a national leader in the use of minimally invasive and robotic surgery. We perform some of the highest number of minimally invasive and robotic surgeries for a pediatric urology program in country. A technique called HIDES, where the already small incisions are hidden below the underwear line, was developed at Children’s Medical Center Dallas.
- Laparoscopic surgery uses small incisions (less than 1 cm) and telescopes to perform surgeries that previously had been performed with larger incisions. The benefits generally include smaller scars, less pain, and quicker recovery. Several minimally invasive surgeries are outpatient surgeries. Even after complex reconstructive surgeries patients are often able to go home after only 1 night in the hospital.
- Robotic surgery is also laparoscopic surgery with smaller incisions, but also with the use of the da Vinci® Si Surgical System from Intuitive Surgical. Use of the surgical robot has several advantages including 3D vision, computer enhanced motion control, and increased range of motion that mimics a human wrist and hand. These advantages of the robot expand the advantages of minimally invasive surgery to more complex reconstructive surgeries such as pyeloplasty, ureteral reimplant, and bladder reconstruction.
Do many places offer robotically assisted surgery for children?
Robotically assisted pediatric urology procedures are quite common in children’s hospitals.
Is robotic surgery safe and effective for children?
As with robotic-assisted procedures for adult patients, published research has shown that robotically assisted surgery is safe and effective for pediatric urology procedures. Much of that research has been led by Dr. Craig Peters, urology division director at Children’s Health, who performed his first robotic pediatric urology surgery in 2002. He has since led the charge in developing this surgical method as a successful minimally invasive technique.
Why has Children’s Health pursued robotically assisted surgery for children?
We’re always looking for more precise and less invasive ways to operate on a child, when such procedures are necessary. Additional robotic solutions for other aspects of pediatric surgery, including a pressure-sensitive robot arm that could perform repetitive, efficient procedures like suturing, are being developed at this time.
What does insurance cover?
In general, there is no extra charge associated with robotically assisted surgery. Charges are usually the same as for laparoscopic or open procedures.
Do parents elect to have this procedure?
Parents are offered the options of open, laparoscopic or robotic surgery based on their child’s specific needs.
Can my child have the IV for surgery once he or she is already asleep?
Yes, that is often what we do. But, your child can also have it after receiving numbing medication on a patch of skin. Then, he or she can go to sleep without a mask, before surgery begins.
How big and how many incisions will there be?
There will be four to five incisions, smaller than 1 centimeter each.
Will my child have to take medicine after the surgery?
Yes. We typically give children some medicine for pain, an antibiotic and sometimes a medicine to reduce irritation caused by the stent we place to drain the kidney.
Will my child have any long-term pain or side effects after surgery?
No, he or she should be back to normal after recovery.
How will my child feel after the surgery and for how long?
Your child will likely have a stomach ache-type discomfort for several days, which should improve each day.
What will my child be able to do, and not do, in the first week after surgery?
Your child should mostly rest for the first week and then slowly increase activity the following week. Each day, he or she can do a little more and walk a little longer. Your surgeon will provide specific guidance about the type of activity your child should avoid, and for how long, depending upon the type of procedure performed.
How long will my child have to stay in bed?
We would like your child to get out of bed the night after surgery, but some patients are not ready to do this until the next day. The earlier he or she gets moving, the quicker he or she will feel better.
Will he or she be able to go up and down the stairs at home?
Yes, that will help your child get moving sooner.