Minimally invasive surgery for newborns and infants: A review of surgical innovations on the example of more than 2000 thoracoscopic and laparoscopic operations

The purpose of this scientific study is to demonstrate that complex endoscopic procedures are possible to correct a wide range of anomalies and diseases in children during the first 3 months of life and lead to results that exceed the results of open surgeries. Study materials and methods: The scientific work is based on a retrospective analysis of the results of treatment of 2828 patients with congenital anomalies of chest and abdominal organs development, who were in the neonatal surgery department of the Ivano-Matreninskaya Children’s Clinical Hospital in Irkutsk from January 1, 2002 to December 31, 2017. Of these, 2065 patients underwent minimally invasive surgeries, and the remaining 763 patients underwent open surgery. All patients were grouped according to the nature of endoscopic procedures, forming two cohorts of patients with surgery on chest organs (418) and on abdominal organs (1647). Clinical subgroups were formed in each group depending on the type of surgical procedure. A retrospective comparison of patient demographic data, intra- and postoperative parameters, recovery characteristics after thoracoscopic and laparoscopic operations was performed. Results: Patients of the compared groups had comparable pre-operative demographic parameters relating to the patient’s age, weight, and gender composition of patient groups. Differences when comparing the two groups of patients became apparent in the study of intra- and postoperative parameters. The reduction in the average duration of endosurgical operations occurred in all the compared groups. After thoracoscopic operations, rapid restoration of respiratory functions and a decrease in the duration of stay in the intensive care ward were noted. As a result of laparoscopy, the time for the start of enteral feeding and the time for switching to full enteral feeding was reduced. The number of analgesics doses reduced by half after laparoscopic operations. The rapid recovery after minimally invasive surgeries decreased the length of stay in the hospital. Conclusion: Minimally invasive surgeries are low-impact and effective interventions to treat children with abnormalities in chest and abdominal organs development. They allow to perform procedures of any complexity, reduce the duration of surgery, and speed up postoperative recovery.