Laparoscopic Minimally Invasive Surgery (Laparoscopy) is a surgical technique that doesn't involve opening the abdomen. During the procedure, a small camera is inserted into the abdominal cavity. This camera transmits images from the abdominal cavity through optical fibers to a video screen, allowing the performing surgeons to see the abdominal organs and perform surgical procedures without the need for a large incision. The laparoscopic approach offers numerous advantages: faster healing after surgery, reduced pain, and improved cosmetic results. This method enables the treatment of a wide range of issues.
Most of the surgical procedures that were previously performed as open surgery can now be conducted using a laparoscopic approach, benefiting from the advantages of minimally invasive surgery, such as faster healing, significant reduction in postoperative pain, early discharge from the hospital compared to open surgery, and enhanced cosmetic outcomes due to smaller incisions.
The Pediatric Urology Department at Shaare Zedek Medical Center is equipped with state-of-the-art laparoscopic equipment, and the department's surgeons have extensive experience in performing laparoscopic procedures. Today, the majority of the procedures in the department are performed using specialized instruments that minimize abdominal incisions to only 3mm. Most kidney surgeries are carried out using the Single Site Laparoscopic Surgery technique, where the entire procedure is performed through a single incision in the child's navel. This technique achieves improved cosmetic results, leaving the child with no visible scars after surgery. Additionally, this approach reduces postoperative pain intensity and complications even when compared to conventional laparoscopic surgery, thanks to the single incision.
A considerable portion of kidney surgeries in the department is performed laparoscopically, including complete nephrectomies for non-functioning kidneys, partial nephrectomies for non-functioning pole of the kidney, testicular fixation procedures, and diagnostic procedures for endocrine diseases. Laparoscopic varicocelectomy for patients suffering from varicocele is also performed.
Currently, some of the laparoscopic surgeries in the department are performed using the da Vinci robot, an advanced robotic surgical system that employs extremely small and compact instruments to perform even infant surgeries. This system enables higher surgical precision, improving success rates (particularly in children), and optimal removal of growths and affected tissues. The primary use of the robot is in reconstructive surgeries. The two most common procedures in this domain are the correction of pelvic kidney outlet anomalies and connecting the ureter to the bladder. These are relatively common conditions often detected during pregnancy or developing in children due to urinary tract infections. The surgery can be performed as early as three months of age.
The da Vinci robot offers a broader range of movement than the human hand and allows a nearly 360-degree view inside the abdominal cavity. The laparoscopic approach leaves the body with almost no visible scars and no significant incision in the abdominal or bladder area, leading to faster healing. Recently, Professor Boris Chertin, the department head, was selected as a mentor for robotic surgeries in Europe.
The department's team is actively involved in several international projects in the field of laparoscopic surgery, including clinical research and development of laparoscopic devices.