Physiological effects of pediatric urological laparoscopic surgery

There is an increasing trend of laparoscopy in pediatric urological practice with more complex and reconstructive procedures being performed in smaller children. The physiological impact of these procedures is not well documented in the pediatric literature and cannot be simply extrapolated from the adult data. This article reviews the current pediatric literature on the physiological effects of both transperitoneal and retroperitoneal laparoscopy. The clinical implication of these changes and the need for proper monitoring is stressed. As surgeons strive to stretch the indications of laparoscopy in pediatric urological practice, the overall beneficial effects of laparoscopy must be balanced with these potential hemodynamic and respiratory changes