Minimally invasive surgery in pediatric trauma: One institution’s 20-year experience

Gustavo Stringel, Min Li Xu, Joseph Lopez

Research output: Contribution to journalArticlepeer-review

12 Scopus citations


Background: Minimally invasive surgery (MIS) for trauma in pediatric cases remains controversial. Recent studies have shown the validity of using minimally invasive techniques to decrease the rate of negative and nontherapeutic laparotomy and thoracotomy. The purpose of this study was to evaluate the diagnostic accuracy and therapeutic options of MIS in pediatric trauma at a level I pediatric trauma center. Methods: We reviewed cases of patients aged 15 years and younger who had undergone laparoscopy or thoracoscopy for trauma in our institution over the past 20 years. Each case was evaluated for mechanism of injury, computed tomographic (CT) scan findings, operative management, and patient outcomes. Results: There were 23 patients in the study (16 boys and 7 girls). Twenty-one had undergone diagnostic laparoscopy and 2 had had diagnostic thoracoscopy. In 16, there were positive findings in diagnostic laparoscopy. Laparoscopic therapeutic interventions were performed in 6 patients; the remaining 10 required conversion to laparotomy. Both patients who underwent diagnostic thoracoscopy had positive findings. One had a thoracoscopic repair, and the other underwent conversion to thoracotomy. There were 5 negative diagnostic laparoscopies. There was no mortality among the 23 patients. Conclusions: The use of laparoscopy and thoracoscopy in pediatric trauma helps to reduce unnecessary laparotomy and thoracotomy. Some injuries can be repaired by a minimally invasive approach. When conversion is necessary, the use of these techniques can guide the placement and size of surgical incisions. The goal is to shift the paradigm in favor of using MIS in the treatment of pediatric trauma as the first-choice modality in stable patients.

Original languageEnglish (US)
Article numbere2015.00111
JournalJournal of the Society of Laparoendoscopic Surgeons
Issue number1
StatePublished - Jan 1 2016
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2016 by JSLS, Journal of the Society of Laparoendoscopic Surgeons.


  • Laparoscopy
  • Minimally invasive surgery
  • Pediatric surgery
  • Thoracoscopy
  • Trauma


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