Abstract
Minimally invasive urology surgery (MIUS) offers several potential benefits which include the avoidance of large incision, less perioperative pain, earlier postoperative mobilization, shorter postoperative ileus, and better cosmetic results.
MIUS does not mean minimally invasive anesthesia.
Complete physical examination and pathological anamnesis should be carried out to identify contraindication to laparoscopy, in particular, heart disease or pulmonary dysfunction. The effect of laparoscopy on this system is a challenge for anesthesiology.
There is no dedicated anesthetic strategy to MIUS in pediatric patients: induction and maintenance are the standard pediatric strategies for anesthesia.
Postoperative pain is the result of ports insertion in the abdominal wall, irritation of phrenic nerve, and distention of peritoneum; its intensity persists for 24 h.
Laparoscopy has been identified as a risk factor of postoperative nausea and vomiting (PONV), therefore routine prophylactic antiemetic therapy should be administered.
Complications include those related to the physiologic effects of the laparoscopic approach (e.g., hemodynamic and respiratory decompensation, gas embolism), surgical maneuvers (vascular or solid organ injuries), and patient positioning.
It’s mandatory for the anesthesiologist to be mindful of potential problems and be ready for a quick approach to them.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Mattei P. Minimally invasive surgery in the diagnosis and treatment of abdominal pain in children. Curr Opin Pediatr. 2007;19:338–43.
Traxel EJ, Minevich EA, Noh PH. A review: the application of minimally invasive surgery to pediatric urology: upper urinary tract procedures. Urology. 2010;76:122–3.
Astuto M, Baroncini S, Borrometi F, Bortone L, Ceschin C, et al. Raccomandazioni per la valutazione anestesiologica e la richiesta di esami preoperatori nei pazienti pediatrici. Gruppo di studio SARNePI.
Brady M, Kinn S, Ness V, et al. Preoperative fasting for preventing perioperative complications in children. Cochrane Database Syst Rev. 2009;(4):CD005285.
Rosenbaum A, Kain ZN, Larsson P, et al. The place of premedication in pediatric practice. Paediatr Anaesth. 2009;19:817–28.
Mukhtar AM, Obayah GM, Elmasry A, Dessouky NM. The therapeutic potential of intraoperative hypercapnia during video assisted thoracoscopy in pediatric patients. Anesth Analg. 2008;106:84–8.
Kalmar AF, Foubert L, Hendrickx JF, et al. Influence of steep trendelenburg position and CO2 pneumoperitoneum on cardiovascular, cerebrovascular, and respiratory homeostasis during robotic prostatectomy. Br J Anaesth. 2010;104:433–9.
Manner T, Aantaa R, Alanen M. Lung compliance during laparoscopic surgery pediatric patients. Paediatr Anaesth. 1998;8(1):25–9.
Bannister CF, Brosius KK, Wulkan M. The effect of insufflation pressure on pulmonary mechanics in infants during laparoscopic surgical procedures. Pediatr Anaesth. 2003;13(9):785–9.
Sakka SG, Huettemann E, Petrat G, Meier-Hellmann A, Schier F, Reinhart K. Transesophageal echocardiographic assessment of hemodynamic changes during laparoscopic herniorrhaphy in small children. Br J Anaesth. 2000;84(3):330–4.
Meininger D, Westphal K, Bremerich DH, et al. Effects of posture and prolonged pneumoperitoneum on hemodynamic parameters during laparoscopy. World J Surg. 2008;32:1400–5.
Joris J, Lamy M. Neuroendocrine changes during pneumo-peritoneum for laparoscopic cholecystectomy. Br J Anaesth. 1993;70(Suppl.):24–9.
Tuna AT, et al. Effect of carbon dioxide insufflation on regional cerebral oxygenation during laparoscopic surgery in children: a prospective study. Rev Bras Anestesiol. 2015;66(3):249–53.
Michelet D, Andreu-Gallien J, Skhiri A, Bonnard A, Nivoche Y, Dahmani S. Factors affecting recovery of postoperative bowel function after pediatric laparoscopic surgery. J Anaesthesiol Clin Pharmacol. 2016;32(3):369–75.
Spinelli G, Vargas M, Aprea G, Cortese G, Servillo G. Pediatric anesthesia for minimally invasive surgery in pediatric urology. Transl Pediatr. 2016;5(4):214–21.
Sinha A, Sharma B, Sood J. ProSeal as an alternative to endotracheal intubation in pediatric laparoscopy. Paediatr Anaesth. 2007;17(4):327–32.
Baum VC. When nitrous oxide is no laughing matter: nitrous oxide and pediatric anesthesia. Paediatr Anaesth. 2007;17:824–30.
McDonnell JG, O'Donnell BD, Tuite D, Farrell T, Power C. The regional abdominal field infiltration (R.a.F.I.) technique: computerized tomographic and anatomical identification of a novel approach to the transversus abdominis neurovascular fascial plane. Anesthesiology. 2004;1:899.
Maitra S, Som A, Baidya DK, et al. Comparison of Ondansetron and dexamethasone for prophylaxis of postoperative nausea and vomiting in patients undergoing laparoscopic surgeries: a meta-analysis of randomized controlled trials. Anesthesiol Res Pract. 2016;2016:7089454.
Tognon C, De Corti F, Michelon S, Gamba PG. Carbon dioxide embolism during laparoscopic lymph-node in a girl: a rare occurrence. J Pediatr Surg Case Rep. 2014;2:377–9.
Cortese G, Tognon C, Servillo G, Gamba P. Anesthesia in pediatric minimally invasive surgery. In: Esposito C, Becmeur F, Steyaert H, Szavay P, editors. ESPES manual of pediatric minimally invasive surgery. Berlin: Springer; 2019.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Cortese, G., Tognon, C., Sara, R., Servillo, G. (2022). Pediatric Anesthesia in MIS Urology. In: Esposito, C., Subramaniam, R., Varlet, F., Masieri, L. (eds) Minimally Invasive Techniques in Pediatric Urology. Springer, Cham. https://doi.org/10.1007/978-3-030-99280-4_10
Download citation
DOI: https://doi.org/10.1007/978-3-030-99280-4_10
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-99279-8
Online ISBN: 978-3-030-99280-4
eBook Packages: MedicineMedicine (R0)