Wani SA, Mufti GN, Bhat NA, Baba AA, Khursheed S and Andrabi FH
Aim: To address our experience of laparoscopic surgery in children during the learning curve. Material and Methods: This was a prospective analysis of patients who underwent various types of laparoscopic surgeries from January 2014 to August 2015. The different types of surgeries, operative time, conversion rate and complications were analyzed during this learning period. Results: A total of 200 patients were operated and different types of lap procedures were performed, both basic and advanced. The majority of the laparosopic surgeries were cholecystectomy 82 (41%), orchidopexy 31 (15.5%), orchidectomy 6 (3%), hydatid cyst liver 18 (9%), appendectomy 14 (7%), varicocelectomy 4 (2%), pyloromyotomy 3 (1.5%), ovarian tumour 7 (3.5%), lap assisted pullthrough 4 (2%), rectopey 3 (1.5%) Meckles diverticulectomy 6 (3%), spleenectomy 2 (1%), mesenteric cyst 4 (2%), diagnostic laparoscopy 9 (4.5%), omental cyst 1 (0.5%), duplication cyst 2 (1%), nephrectomy 1 (0.5%), leveling biopsy 2 (1%), deroofing of left renal cyst 1 (0.5%). During the early period of learning curve, operative time, conversion rate and complications were more which decrease with experience and learning skills. Conversions were for complicated appendicitis, hydatid cyst liver, spleenectomy and pyloromyotomy. Conclusion: Laparoscopic surgery in children has lot of advantages, is very promising and techniquelly demanding. Complications do occur during the learning curve. The more operative time and more conversion rate during the learning curve should not be regarded as complication. Postdoctoral residents of pediatric surgery should be trained so that pediatric lap becomes widely available with good results.
