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Stellenwert der Laparoskopie in der Kinderurologie

The position of laparoscopic surgery in pediatric urology

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Zusammenfassung

Mit zunehmender Erfahrung in der Laparoskopie vollzieht sich auch in der Kinderurologie die Evolution von ablativen hin zu rekonstruktiven Eingriffen. Neben den etablierten Verfahren der laparoskopischen Nephrektomie und der Orchidopexie haben auch die Heminephrektomie und die Pyeloplastik längst den Charakter von Kasuistiken mit Demonstration der prinzipiellen Machbarkeit verloren und sind zu standardisierten Therapiealternativen herangereift. Wie in unserem eigenen Patientengut nimmt dabei, bedingt auch durch instrumentelle Weiterentwicklung, der Anteil an Kleinkindern zu. Viele dieser Eingriffe setzen allerdings eine hohe Erfahrung in laparoskopischen Präparations- und Nahttechniken voraus und bleiben somit Zentren mit großer Erfahrung in der Erwachsenenlaparoskopie vorbehalten, wobei die tägliche Erfahrung mit laparoskopischen Eingriffen bei Erwachsenen urologische gegenüber kinderchirurgischen Kliniken prädestiniert.

Abstract

With growing experience in laparoscopic techniques there is a switch in pediatrics from ablative surgery to reconstructive procedures. Besides the established procedures such as laparoscopic nephrectomy and orchidopexy, procedures like heminephrectomy and pyeloplasty have proven practicable and become standard therapies in children and infants. Due to technical advances, as shown for our own patients, the number of treated infants is still increasing. However, laparoscopic reconstructive procedures presuppose a good deal of experience in preparation and suture techniques, and remain reserved for centers with daily experience in laparoscopy. Daily experience with difficult urological laparoscopic procedures in adults will remain more common than in pediatric centres.

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Authors and Affiliations

  1. Urologische Klinik, SLK-Kliniken Heilbronn, Akademisches Lehrkrankenhaus der Universität Heidelberg, Am Gesundbrunnen 26, 74078, Heilbronn

    D. Teber, S. Subotic, M. Schulze, C. Stock, S. Eskicorapci &  J. Rassweiler

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  1. D. Teber
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  2. S. Subotic
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  3. M. Schulze
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  4. C. Stock
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  5. S. Eskicorapci
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  6. J. Rassweiler
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Correspondence to J. Rassweiler.

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Teber, D., Subotic, S., Schulze, M. et al. Stellenwert der Laparoskopie in der Kinderurologie. Urologe 45, 1145–1154 (2006). https://doi.org/10.1007/s00120-006-1150-3

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