Hospital Alemao Oswaldo Cruz, Sao Paulo, Brazil.
Curr Opin Urol. 2010 Jul;20(4):330-5. doi: 10.1097/MOU.0b013e32833aa3ed.
Minimally invasive surgery used to play a role only as a diagnostic tool in pediatric urology, being used in a narrow range of conditions like cryptorchidism. With the breakthrough of laparoscopic techniques, skilled surgeons and remarkably the advances in robotic-assisted surgery, laparoscopy has gained a role for treatment purposes in pediatric urology.
Many reconstructive laparoscopic procedures notably with the aid of robotic-assisted surgery such as pyeloplasty and ureteral reimplantation and even more challenging procedures like appendicovesicostomy became feasible with similar results to those with open surgery. Even though minimally invasive approaches may have the drawback of greater technical difficulty, they have the advantages of shorter hospital stays, lesser postoperative pain and better cosmesis.
There is still a lack of controlled prospective randomized trials assessing the differences between open and minimally invasive techniques for reconstructive pediatric urology. Nevertheless, the minimally invasive approach has proven itself to be feasible and well tolerated for most reconstructive procedures.
微创外科曾经仅在小儿泌尿外科中作为一种诊断工具发挥作用，仅在隐睾等少数情况下使用。随着腹腔镜技术的突破、熟练的外科医生以及机器人辅助手术的显著进步，腹腔镜已在小儿泌尿外科中获得了治疗用途。
许多重建性腹腔镜手术，尤其是在机器人辅助手术的辅助下，如肾盂成形术和输尿管再植术，甚至更具挑战性的手术，如阑尾-膀胱吻合术，都变得可行，其结果与开放手术相似。虽然微创方法可能具有技术难度较大的缺点，但它们具有住院时间短、术后疼痛少和美容效果好的优点。
目前仍缺乏评估开放手术和微创技术在小儿重建泌尿外科方面差异的对照前瞻性随机试验。然而，微创方法已被证明对于大多数重建手术是可行且耐受良好的。
