Pediatric Urological Surgery

During laparoscopic surgery, a surgeon makes three to five tiny incisions instead of one large incision. Then a thin tool with a small video camera and light attached to it — known as a laparoscope — is inserted through one of these incisions. The camera transmits images to a video monitor, giving the surgeon a clear view of the surgical site. The team then uses a set of specially designed tools to perform the procedure.

Once the surgery is complete, the incisions are closed, and most patients can resume normal activities within a matter of days. Some of the laparoscopic procedures we perform include:

• Repair of an undescended testicle
• Total or partial nephrectomy (removal of all or part of a diseased kidney)
• Removal of kidney cysts
• Varicocele ligation (surgery to treat enlarged veins in the scrotum)

Endoscopic procedures involve the use of a cystoscope, a small instrument that, like a laparoscope, has a video camera and light attached to it. During this type of procedure, a surgeon passes the cystoscope through natural openings in the body, such as the urethra, instead of making incisions in the skin.

With camera images as a guide, the team then uses specialized surgical tools to perform the procedure. Similar to laparoscopic procedures, most patients can resume normal activities shortly after surgery. We typically use endoscopic surgeries to treat:

• Bladder tumors
• Kidney stones
• Vesicoureteral reflux (when urine flows backward to the bladder)
• High-pressure neurogenic bladders (when nerves to the bladder do not work properly, affecting bladder function)

Minimally invasive techniques are not appropriate for all surgeries. In collaboration with families, we carefully evaluate each child’s situation to determine the best approach.

• Contact us if your child is sick. We may need to reschedule the procedure if your child has cold or flu symptoms.
• Pack loose, comfortable clothing. Sweatpants, T-shirts or shirts that button up the front are ideal, depending on the type of surgery your child is having.
• Bring items to entertain and comfort your child. Suggestions include a favorite stuffed animal or blanket, books and videos (with headphones).
• Review your surgery handout. The document provided when your child’s surgery was scheduled gives detailed guidelines for eating, drinking and bathing prior to surgery.

Check in. When you arrive, someone at the reception desk will guide you through the admissions process. A member of our staff will then escort your child to the pre-operative area, perform a quick physical exam, update the medical chart and provide a hospital gown.

Consult with your surgeon and anesthesiologist. Both you and your child will meet your surgeon to discuss any last-minute concerns. Next, your child’s anesthesiologist will discuss the type of anesthesia to be used and how it will be administered.

Complete final pre-surgical tasks, head to operating room. Your child’s surgical nurse will perform a final check to ensure all pre-surgical tasks are complete before bringing your child to the operating room. We often give relaxation medicine to younger patients to help with separation from a parent or caregiver. Children can take a comfort item with them into surgery, such as a clean stuffed animal or blanket.

Join your child once surgery is complete. After surgery, your child will be taken to the post-anesthesia care unit (PACU) to recover. Once you have spoken with the surgeon to discuss the outcome of the procedure, you will join you child in the PACU. Depending on the type of surgery, some children are released the same day while others are required to stay overnight.