Minimally Invasive Pediatric Surgery
Cedars-Sinai's pediatric urologists specialize in minimally invasive laparoscopic, endourologic and robotic surgical techniques that strive to reduce discomfort and shorten hospital stays for their young patients. Most of these procedures can be done on an outpatient basis, minimizing stress for your child.
Advantages of minimally-invasive approaches over conventional, open surgery include:
- Reduced need for an overnight hospital stay
- Reduced need for postoperative pain medicine
- Generally, a faster return to full activity for your child and to work for you
In laparoscopic surgery, the pediatric urologist fills the patient's abdomen with gas to create space in which to work. Instead of large incisions, the pediatric urologist passes miniaturized instruments through tiny, five-millimeter tubes, called "ports". Using a laparoscopic camera, he visualizes the surgical field on large, high definition video monitors, which provides the magnified views needed for very delicate surgeries.
Laparoscopic procedures for children available at the Cedars-Sinai Academic Urology Practice include:
- Orchidopexy to bring down undescended testicles from the abdomen
- Pyeloplasty for obstructed kidneys
- Diagnosis and treatment of disorders of sexual development
- Nephrectomy (removal of a kidney)
Endourologic surgery involves specialized instruments that can enter the urinary tract via the urethra (the tube carrying urine from the bladder to outside the body), eliminating the need for incisions. At Cedars-Sinai, pediatric urologists have access to endourologic equipment designed especially for pediatric surgery.
Pediatric endourologic procedures include:
- Deflux injection for vesicoureteral reflux, or VUR, a condition in which urine flows backwards from the bladder into the ureters or kidneys
- Removal of stones from the kidney, ureter or bladder
- Treatment of posterior urethral valves, a congenital urinary tract blockage, in infants
- Endopyelotomy for obstructed kidneys
Robotics offer an important advance in laparoscopic surgery by facilitating very delicate urologic procedures. The da Vinci® surgical system used at Cedars-Sinai reproduces the dexterity of the human hand while providing a three-dimensional view of the surgical field. If your child needs urologic surgery, ask your pediatric urologist if robotic surgery might be an option.
Pediatric Urology at Cedars-Sinai
Children are affected by different urologic conditions than adults, and their smaller bodies respond differently to anesthesia and surgical incisions. For these reasons, the Cedars-Sinai Urology Academic Practice is guided by the philosophy that pediatric patients are best evaluated and treated by pediatric specialists. Andrew Freedman, MD and Barry Duel, MD, the Urology Academic Practice's pediatric urologists, devote their practice to the evaluation and treatment of children. Both are board certified in Pediatric Urology, and offer broad experience in minimally invasive laparoscopic procedures. Dr. Barry Duel is experienced in robotic procedures adapted for the needs of children. The majority of their procedures are conducted on an outpatient basis, with both outpatient and inpatient surgeries attended by specialized pediatric anesthesiologists.