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The Role of Laparoscopy and Thorascopy in Pediatric Trauma
Min Li Xu, MD, Joseph Lopez, MD, Whitney McBride, MD, Samir Pandya, MD and Gustavo Stringel, MD, MBA, Maria Fareri Children's Hospital, New York Medical College, New York NY

Abstract: Minimally invasive surgery for diagnosis and treatment of pediatric trauma remains selective and controversial. Recent studies have tried to show the validity of using minimally invasive techniques to decrease the rate of negative and non-therapeutic laparotomy and thoracotomy. The purpose of the study is to evaluate the diagnostic accuracy and therapeutic options. Methods: We reviewed all pediatric trauma patients ages 14 and younger who underwent either laparoscopic or thoracoscopic procedure at our institution. Each case was evaluated for mechanism of injury, CT scan findings, operative methods, and patient outcomes. Results: There were 14 males and 7 females. 19 patients underwent diagnostic laparoscopy and 2 patients underwent diagnostic thoracoscopy. 14 out of 19 patients had positive diagnostic laparoscopy and all required interventions. Laparoscopic therapeutic interventions were performed on 5 (35%) patients, while the remaining 9 (65%) patients required conversion to laparotomy for repair of their injuries. Both patients who underwent diagnostic thoracoscopy had positive findings; one had thoracoscopic repair, and the other patient was converted to open thoracotomy. There were five negative diagnostic laparoscopies, 4 patients avoided unnecessary laparotomy. One of those patients had a delayed intestinal perforation requiring open surgical repair. There were no deaths among the 21 patients. Conclusions: The use of laparoscopy and thoracoscopy in pediatric trauma can avoid unnecessary laparotomy and thoracotomy. Some of the injuries encountered can be repaired by minimally invasive approach. If conversion is necessary, the use of these techniques can guide to the placement and size of surgical incisions.

Objective: To evaluate and discuss the role of laparoscopy and thoracoscopy in pediatric trauma patients.

Objective Content: At the end of the presentation the learner will be able to discuss the role of laparoscopy and thoracoscopy in pediatric trauma victims.

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