At the Minimally Invasive Surgery Center, our surgeons perform a variety of minimally invasive and robotic procedures in order to correct many pediatric conditions.
Pediatric Surgery Procedures
Pediatric surgeons are able to perform a majority of pediatric surgical cases using laparoscopic, otherwise known as minimally invasive, techniques. These are a few of the most common.
An appendectomy refers to the removal of the appendix. The inflammation and infection of the appendix is the most common cause of emergency surgery in children. At UPMC Children's Hospital of Pittsburgh, our surgeons perform about 500 appendectomies every year, and nearly all of them -- more than 99 percent -- are done using minimally invasive techniques.
A resection is the partial removal of an organ or other part of the body. Bowel resections frequently are done using minimally invasive methods.
An ileostomy is an operation in which the small intestine is attached to the abdominal wall. This surgery often is done minimally invasively.
Cholecystectomy is a surgery to remove the gallbladder. Laparoscopic cholecystectomy is a minimally invasive way of doing this surgery.
Nissen fundoplication is a procedure to treat gastroesophageal reflux disease, or GERD, as well as hiatal hernia.
Splenectomy is a procedure that partially or completely removes the spleen.
Urological Surgery Procedures
In pediatric urology, many conditions can be treated through minimally invasive surgery. Here are some of the conditions we see in Pediatric Urology and the surgeries that can fix them.
Ureteropelvic junction obstruction (UPJ obstruction)
This is a condition where there is impaired drainage from one or both kidneys. It may be detected by swelling inside the kidney on prenatal ultrasound or can present with back pain, vomiting, or infection after birth. Pyeloplasty is an operation that fixes this blockage. Minimally invasive surgical options we offer correct this condition include robotic pyeloplasty or pure laparoscopic pyeloplasty.
Vesicoureteral reflux (VUR)
Normally, the kidneys make urine and it only travels from the kidney down to the bladder. In children with vesicoureteral reflux, urine also travels from the bladder back up to the kidneys. This can result in kidney infections and permanent kidney damage or scarring. Minimally invasive surgical options we offer to correct this condition include subureteric injection (otherwise known as Deflux) and robotic ureteral reimplantation. Robotic ureteral reimplantation changes how the ureteral tunnels lie within the bladder so the urine no longer travels back to the kidney from the bladder.
Renal duplication abnormalities
Usually, kidneys have one ureter tube that drains the kidney. Sometimes, a kidney can have two separate parts with two different ureters that drain it. This can be associated with blockage of a portion of the kidney that can interfere with kidney function or cause infection or rarely incontinence, which is the inability to control one’s urination. Minimally invasive surgical options we offer to correct renal duplication abnormalities include robotic partial nephrectomy (removing a portion of the kidney) and robotic or laparoscopic ureteroureterostomy (attaching one ureter to another).
Urachal abnormalities
The urachus is a connection between the bladder and the belly button that normally closes before birth. If it does not close or only partially closes, then urine may drain from the belly button or a cavity that is at risk for infection and possibly cancer in the future. We offer robotic or laparoscopic urachal excision as a minimally invasive surgical option to correct these conditions.
Undescended testes
In boys, the testicles (or testes) start out in the abdomen (belly) and typically descend into the scrotum before birth. Sometimes they stop short; sometimes don’t even make it out of the abdomen. This can place testes at risk for cancer and decreased fertility in the future. We offer laparoscopic orchiopexy as a minimally invasive technique to bring testes in the abdomen down to the scrotum where they belong.
Non-functioning dysplastic kidneys
In either boys or girls, a kidney may not have developed properly during development. These non-functioning kidneys may lead to static urine -- Urine that stands still and is not eliminated effectively due to an obstruction or an inherent muscular problem with the bladder or ureters. As a result, the urine becomes stagnant and this increases the chances for infection. Static urine can cause pain, chronic infection, kidney stones, and rarely, high blood pressure. These unhealthy kidneys may be removed laparoscopically or robotically.
Renal tumors
Abnormal growths in the kidney may be either benign or cancerous. Although rare in children, renal tumors may be removed successfully in a minimally invasive fasion either robotically or laparoscopically. Depending on the size and location of the tumor, either a partial nephrectomy or radical nephrectomy will be needed. When a partial nephrectomy is performed, only the tumor is removed. When a radical nephrectomy is performed, the entire kidney is removed.
Testicular tumors and retroperitoneal lymph node dissection
Certain types of testicular tumors require additional surgery to remove the lymph nodes that drain the testicle(s). These lymph nodes are found around the great vessels of the body. These vessels are located in the retroperitoneum (toward the back of the abdominal cavity). These lymph nodes can be removed laparoscopically or robotically.
Find out about pediatric stone disease.
Find out about neurogenic bladder problems and how we can help them.
