Frequently Asked Questions About Minimally Invasive Pediatric Urological Surgery

Many pediatric urological diagnostic and surgical techniques can be done with minimally invasive surgery (MIS). From diagnostic endoscopy to laparoscopic and robotic surgery, these innovative procedures are done with specially designed thin instruments through tiny incisions.

The benefits of minimally invasive urological surgery for our young patients are many, including:

• Fewer complications
• Reduced pain
• Reduced blood loss
• Less scarring
• Less damage to tissue and muscle
• Shorter stay in the hospital
• Quicker return to normal activities

Mohan S. Gundeti, MD, chief of pediatric urology at Comer Children's Hospital at the University of Chicago, is an expert in minimally invasive procedures for all types of urological conditions, including the most complex congenital anomalies.

• What is endoscopy?
• What is laparoscopy?
• What is robotic surgery?
• What type of minimally invasive surgery is right for my child?
• When is open surgery necessary?
• What are the complications of minimally invasive surgery?

Q. What is endoscopy?
A. Endoscopy is a minimally invasive procedure that allows surgeons to inspect body organs using a probe that is inserted into natural body openings. Images from a tiny camera on the end of the probe are projected on a video screen. Endoscopy is used for diagnosing conditions of the bladder, ureter and kidneys.

Q. What is laparoscopy?
A. In laparoscopic surgery, the surgeon makes two to three small (1/4 to 1/2 inch) incisions in the abdominal skin or posterior abdominal wall. These keyhole openings allow for the insertion of small surgical instruments to be placed in the abdominal cavity. A tiny camera at the tip of the instruments allows the surgeon to view the operating field. Laparoscopy is generally done under general anesthesia.

Q. What is robotic surgery?
A. Robotic-assisted surgery is the newest and most exciting technique in minimally invasive surgery. Offering the precision of traditional open surgery and the shorter recovery time of minimally invasive surgery, robotic-assisted surgery is now available for intricate urological procedures on children. Comer Children’s Hospital uses the da Vinci Surgical System for all robotic surgeries. »Learn more about pediatric robotic urological surgery

Q. What type of minimally invasive surgery is right for my child?
A. The pediatric urology team will determine the best type of surgery for your child based on your child’s thorough exam, medical history and diagnosis. Many urological conditions are now diagnosed and treated with minimally invasive techniques. Robotic-assisted surgery is typically used when a complex reconstruction such as pyeloplasty (kidney outflow obstruction), cystoplasty (bladder augmentation) or Mitrofanoff appendicovesicostomy (catheterize channel to empty bladder).

Q. When is open surgery necessary?
A. Reconstruction of penile and genitalia anomalies, except intra-abdominal and impalpable testis, requires open surgery. Urologic surgery for most newborns is also done by the open approach because the small size of these patients necessitates a view of the full surgical area.

Q. What are the complications of minimally invasive surgery?
A. All surgeries involve risks such as bleeding, infection, and injury to nearby organs. The risk of complications with MIS is lower than with open surgery. Surgeons at Comer Children’s Hospital are very experienced in minimally invasive surgery for children.