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Erschienen in:
14.05.2019 | Pediatric Anesthesia (J Lerman, Section Editor)
Laparoscopic Surgery in Pediatrics
Erschienen in: Current Anesthesiology Reports | Ausgabe 3/2019
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Purpose of Review
The motivation of this review is to deepen our understanding of the physiological changes that occur during laparoscopic surgery in pediatric patients in order to detect possible complications in time to intervene and to provide the most appropriate monitoring.
Recent Findings
Laparoscopic surgery has evolved rapidly in recent years and is considered a standard procedure in pediatric surgery. This surgical technique includes the use of pneumoperitoneum which, when combined with extreme positions (e.g., steep Trendelenburg) leads to hemodynamic, respiratory, and neuroendocrine changes, among others, which are more evident in neonates, infants, and severely ill children. During laparoscopic procedures in children, adaptive changes are observed. There are studies that focus on the relationship between laparoscopic surgery and regional oxygen saturation (rSO2). Cerebral oximetry with near-infrared spectroscopy (NIRS) could be useful for detecting cerebral oxygenation changes in time.
Summary
During laparoscopic surgery, substantive physiological changes occur. The pediatric population, especially neonates, is more sensitive to these changes than adults and may suffer sequelae as a result. Thus, we recommend further research to understand the usefulness of the specific intraoperative monitoring to prevent these sequelae.