Laparoscopic Minimally Invasive Surgery is a method of surgery that doesn't involve opening the abdomen. During the procedure, a small camera is inserted into the abdominal cavity, transmitting the image from the abdomen through optical fibers to a video screen. This allows the operating doctors to see the abdominal organs and perform surgical procedures without the need for a large incision. The method offers numerous advantages: faster post-operative recovery, reduced pain, and better cosmetic results. Laparoscopic surgery enables the treatment of a wide range of issues.
Most of the surgical procedures that were previously done through open surgery can now be performed using a laparoscopic approach, utilizing all the benefits of minimally invasive surgery such as faster healing, significantly reduced post-operative pain, the potential for earlier discharge from the department compared to open surgery, and, of course, improved cosmetic outcomes (appearance of scars), as the scars left from laparoscopic surgery are much smaller compared to those from traditional open surgery which involves a wide incision.
The Pediatric Urology Department at Shaare Zedek Medical Center is equipped with advanced laparoscopic equipment, and the department's physicians have extensive experience in performing laparoscopic surgeries. Today, the majority of surgeries in the department utilize specialized instruments that minimize the extent of abdominal incisions to just 3mm. For most kidney surgeries, the department's surgeons use the Single Site Laparoscopic Surgery technique. In this method, the entire procedure is conducted through a single incision in the child's umbilicus. This technique achieves improved cosmetic results, leaving the child with no visible scar after the surgery. Furthermore, this method reduces post-operative pain intensity and manages complications rates even compared to conventional laparoscopic surgery, due to the single incision instead of multiple incisions.
The majority of kidney surgeries in the department are performed laparoscopically. These include surgeries for complete kidney removal in children with non-functioning kidneys, partial kidney removal surgeries such as pole-preserving partial nephrectomies for non-functioning segments, plastic surgeries to expand the renal pelvis (Laparoscopic Pyeloplasty), surgeries to fix undescended testicles intraperitoneally, a variety of diagnostic surgeries in patients with endocrine diseases, and laparoscopic varicocelectomy for patients suffering from varicocele (enlarged veins in the scrotum).
Currently, some of the department's laparoscopic surgeries are performed using the da Vinci robot, an advanced robotic surgical system that employs very small and compact instruments. This system offers higher precision in surgery, leading to increased success rates (especially in children) and optimal removal of masses and affected tissues. The primary use of the robot is for reconstructive surgeries. The two most common surgeries in this field are the reconstruction of the renal pelvis outlet and the connection of the ureter to the bladder, both common conditions that are often detected during pregnancy or develop in children due to urinary tract infections. The surgery can be performed from the age of three months. The robot's range of movement is broader than that of the human hand, allowing a nearly 360-degree view within the abdominal cavity. The laparoscopic approach leaves the body with minimal scars and without a significant incision in the abdominal or pelvic region, resulting in faster healing.
Recently, Prof. Boris Chertin, the department's director, was selected as a robotic surgery instructor in Europe. The department's team participates in several international projects in the field of laparoscopic surgery, including clinical studies and the development of laparoscopic devices.