Minimally Invasive Surgery for Children

Minimally Invasive Surgery at the Center for Children's Surgery

Minimally invasive surgery is an innovative technique that uses smaller incisions, compared with traditional “open” surgery. Whenever possible, our surgeons perform these procedures rather than traditional surgery. They often use advanced technology to aid them in performing minimally invasive surgery, including small cameras and even robots. Our specialists are among the best in the field of pediatric minimally invasive surgery.

What are the benefits of minimally invasive surgery?

Compared with traditional surgery, minimally invasive surgery offers:

• Less tissue damage because we make smaller incisions
• Less pain
• Shorter hospital stays
• Quicker recovery and return to regular activities
• Lower risk of infection
• Less scarring internally and smaller and less obvious scars on the skin
• Magnified, detailed, real-time images for surgeons work from

What are the types of minimally invasive surgery?

• Laparoscopy: Procedures performed in the abdomen
• Thoracoscopy: Procedures performed in the chest
• Fetoscopy: Procedures performed on an unborn baby in the womb (uterus)

How do I help prepare my child for minimally invasive surgery?

Preparing for minimally invasive surgery is like preparing for other surgical procedures. Please make sure to:

• Follow the eating and drinking rules so your child’s stomach is empty before getting anesthesia. If their stomach isn’t empty, the contents can come up and enter their lungs (a serious problem called aspiration).
• Discuss your child's medicines with the anesthesia team to find out if your child can take them before the procedure. Your child may be able to take medicine with a sip of water.

Learn more about preparing for surgery at Children’s Colorado.

What happens during minimally invasive surgery?

Here’s what to expect from minimally invasive procedures:

Receiving anesthesia

Your child receives general anesthesia before the surgery. Anesthesia keeps your child asleep so they don’t feel pain or remember the procedure.

Making an incision and viewing the area

Your child’s surgeon makes a small incision (about 2 to 5 millimeters) to access the appropriate part of the body. A 2-mm incision is about the size of a peppercorn, while a 5-mm incision is about the size of a chickpea.

The surgeon places surgical instruments through special ports (openings). They also insert a camera with a light through the port to allow them to see the area. The surgeon fills the area with safe carbon dioxide gas to expand it, which provides a better view.

Performing surgery

Your child’s surgeon surgeon uses surgical instruments to explore, remove or repair the problem inside the body. After the procedure, the surgeon closes the port site with absorbable sutures (stitches) under the skin.

Surgery time for minimally invasive procedures varies based on the procedure. Most surgeries take between 30 minutes and 2 hours, and some more complex procedures take longer.

What can my child expect from minimally invasive surgery?

Your child’s hospital stay varies depending on the type of procedure they had and usually lasts 1 to 5 days.

• Side effects your child may have after minimally invasive surgery include:
  • Nausea and vomiting: Anesthesia medicines or surgical movements in your child’s body can cause these symptoms. We use special approaches to reduce nausea, vomiting and pain after surgery.
  • Shoulder pain: Your child may have shoulder pain for up to 2 to 3 days. The pain comes from the carbon dioxide gas that is used during the procedure and goes away on its own.
• Recovery time depends on what procedure your child had, but many children return to most regular activities within 3 to 7 days. Your child may take a shower two days after surgery, but they shouldn’t swim or take a bath for at least one week.

How do I care for my child during recovery from minimally invasive surgery?

Your child’s care team provides a detailed plan to make their recovery as smooth as possible.

• Pain control: Your child’s doctor will provide a pain management plan for you to follow at home. Your child may only need acetaminophen (such as Tylenol^®) or ibuprofen (such as Motrin^®) to control pain. In some cases, we may prescribe pain medicine for a short time.
• Eating and drinking: In most cases, your child can return to their regular diet after they’re discharged from the hospital.
• Activity: Your child should return to activities gradually. If your child is taking prescription pain medicine, keep them at home. Certain complex procedures require specific activity instructions and limitations. Your child's care team will provide these instructions to you.

Why choose us for minimally invasive surgery?

Our expert pediatric surgeons perform both complex and routine minimally invasive procedures in several surgical specialties, treating unborn babies to adolescents. The departments that commonly offer minimally invasive surgery include: Pediatric Surgery, Pediatric Urology and Pediatric and Adolescent Gynecology.

At Children’s Colorado, doctors from many specialties work together as a team, so your child receives the most comprehensive care. This multidisciplinary approach ensures that the surgical team considers treatment from every angle in order to recommend the best surgical or nonsurgical treatment options for your child’s unique needs.

Children’s Colorado also offers a one-of-a kind continuum of care for babies with conditions diagnosed prenatally, including:

• Expert care team members at the Colorado Fetal Care Center
• Personalized delivery planning with our top-ranked NICU
• Follow-up care at our dedicated multidisciplinary clinic

What types of minimally invasive surgery do we perform?

Common minimally invasive procedures include:

• Appendectomy to treat an inflamed appendix (appendicitis)
• Pyloromyotomy to treat problems in the outlet of your child’s stomach (hypertrophic pyloric stenosis)
• Fundoplication to treat gastroesophageal reflux disease (GERD)
• Gastrostomy tube placement to deliver nutrition to your child’s stomach
• Intussusception surgery to treat blockages in your child’s intestines
• Splenectomy to remove part or all of the spleen
• Cholecystectomy to remove the gallbladder, usually to treat gallstones
• Inguinal hernia repair to fix tissue that bulges through the muscles in your child’s abdomen
• Liver biopsy to obtain a tissue sample, so we can check for conditions that affect your child’s liver

Complex minimally invasive procedures include:

• Fetoscopic procedures to perform surgery on a baby while still in the uterus
• Minimally invasive bariatric surgery (weight loss surgery) for severe obesity
• Minimally invasive urologic surgery
• Minimally invasive ovarian procedures
• Colectomy (surgery to remove all or part of the colon) and ileocolectomy (surgery to remove part of the ileum, a part of the small intestine)
• Ileoanal J-pouch procedures (surgery to treat ulcerative colitis or polyposis)

Thoracoscopy

• Thoracoscopic repair of esophageal atresias with tracheoesophageal fistula (TEF) (surgery to repair a birth defect in the esophagus and trachea)
• Thorascopic repair of congenital diaphragmatic hernia or diaphragmatic eventration (diaphragm is positioned in an abnormally high position) in qualified babies
• Thorascopic lobectomy (surgery to remove part of the lung)
• Thoracoscopic Nuss bar placement (surgery to treat pectus excavatum)
• Thoracoscopic lung biopsy or mass resection

Laparoscopy

• Laparoscopic repair of duodenal atresia (first part of the small bowel does not develop properly)
• Laparoscopic management of Hirschsprung disease
• Laparoscopic adrenalectomy (removal of adrenal gland)

If you have any questions or concerns after the procedure, call the ParentSmart Healthline at 1-855-KID-INFO (543-4636). Caring pediatric nurses are available 24 hours a day, 7 days a week to help answer your questions.