Laparoscopy in pediatric urology.

Laparoscopy has been used in pediatric urology for the diagnosis of nonpalpable testes for more than fifteen years. Expansion of pediatric urologic applications of laparoscopic surgical techniques is inevitable with the recent explosion of urologic laparoscopy. While the needs are distinct and at times divergent from those in the adult population, many benefits may be realized with this developing technology in children. Refinement of diagnostic capabilities as well as interventional procedures for the undescended testis are being developed. Increased use for varicocele treatment and intersex evaluation can be expected. Potential applications of laparoscopic techniques for the pediatric urologist include nephrectomy for various benign diseases, ureteral surgery for reflux, bladder autoaugmentation, and hernia repair. Laparoscopic possibilities are limited only by imagination and technology. A skeptical approach is justified and judicious application of these technologies in children is essential. Just as the child is not a small adult, pediatric laparoscopy is not just the use of smaller instruments.