When Your Child Needs Laparoscopic Urologic Surgery

Side view of cross section of child's pelvis showing bladder and urethra. Instruments are inserted in pelvis through skin. One instrument is shining light where another instrument is grasping part of urinary tract.

Your healthcare provider has recommended laparoscopic urologic surgery for your child. This is to help diagnose or treat a problem in the urinary tract. Laparoscopic surgery uses smaller incisions than “open” surgery. This means your child is likely to have less pain and a faster recovery. 

What are the benefits of laparoscopy?

Laparoscopy is a type of surgery that uses a long, thin, tube-like instrument with a camera and light (laparoscope). The scope allows the surgeon to see and operate inside the belly (abdomen). Small surgical instruments are also used. Laparoscopy often involves the following:

  • A short hospital stay (your child may even be able to go home the same day)

  • A faster recovery than with open surgery

  • Smaller scars on the skin

  • Less pain after the procedure

How do we prepare for the procedure?

  • Tell the surgeon about any medicines your child takes. Include herbs, supplements, and over-the-counter medicines. You may need to have your child stop taking certain medicines, such as ibuprofen, before the surgery.

  • Discuss with the surgeon any allergies and health problems your child has.

  • Follow any directions your child is given about eating and drinking before surgery. If you do not follow the instructions, the surgery may have to be postponed.

  • Meet with the child’s anesthesiologist before the surgery. He or she gives your child medicine so your child sleeps and does not feel pain during the surgery. The anesthesiologist also monitors your child’s heart rate, blood pressure, and oxygen levels during the procedure.

What happens before the procedure?

Your child will be given a mild sedative to help him or her relax. When it’s time for the procedure, your child will be given general anesthesia (medicine to help him or her sleep through the surgery). A soft, plastic tube (catheter) may be put into the bladder to drain urine during or after surgery.

What happens during the procedure?

Once your child is asleep, the laparoscope is passed through a small incision made in the abdomen. The surgeon uses a small camera on the scope to see images on a video monitor. Gas is used to inflate the abdomen to make room for the surgeon to see and work. Surgical instruments are put through the other small incisions when needed. Depending on what the surgeon finds, he or she may be able to treat the problem at this time. In some cases, a surgical robot helps with the surgery.

What happens after the procedure?

  • Your child will be taken to a recovery room to recover from anesthesia. You may be able to join your child at this time.

  • Nurses will care for and monitor your child during recovery.

  • Your child may feel some shoulder pain. This is due to irritation from the gas used to inflate the abdomen.

  • Your child may feel some pain at the incision sites. Medicine will be given to ease any pain.

  • If a catheter was placed in the bladder, it may be removed before your child goes home.

  • Your healthcare provider will tell you when it’s safe for your child to leave the hospital.

Follow-up care

You will receive discharge instructions when it’s time for your child to leave the hospital. Follow these carefully. Make a follow-up appointment with the doctor within the next 2 to 6 weeks. Your child’s condition and future care will be discussed at the appointment. 

When to call your child's healthcare provider

Unless advised otherwise by your child’s healthcare provider, call the provider right away if:

  • Your child is of any age and has repeated fevers above 104°F (40°C).

  • Your child is younger than 2 years of age and a fever of 100.4°F (38°C) continues for more than 1 day.

  • Your child is 2 years old or older and a fever of 100.4°F (38°C) continues for more than 3 days.

Also call your child’s healthcare provider if your otherwise healthy child has any of the following:

  • Chills

  • An incision site or sites that are red, swollen, draining, or bleeding

  • An incision site or sites that have a bad odor

  • Increased swelling at the incision site

  • Severe abdominal pain or bloating

  • Nausea or vomiting

  • Refusal to eat

  • Pain that doesn’t go away or that gets worse with prescribed medicine

  • Shortness of breath or trouble breathing

  • If going home with tubes or drains, call if they are not working properly or come out

  • Numbness, tingling, or pain in the lower leg

Tips for helping your child prepare

Many hospitals have staff trained in helping children cope with their hospital experience. This person is often a child life specialist. Ask your child’s health care provider for more information about this service. There are also things you can do to help your child prepare for the procedure. The best way to do this depends on your child’s needs. Start with the tips below:

  • Use brief and simple terms to describe the procedure to your child and why it’s being done. Younger children tend to have a short attention span, so do this shortly before the surgery. Older children can be given more time to understand the procedure in advance.

  • Make sure your child understands which body parts will be involved in the procedure.

  • As best you can, describe how receiving anesthesia will feel. For instance, the medicine may be given as gas that comes out of a mask. The gas may smell like bubble gum or another flavor. It will make your child sleepy so he or she naps during the procedure.

  • Tell your child what he or she will likely see in the operating room during the surgery. For instance, you could mention who will be there or that the person giving your child medicine to help your child nap will be in uniform.

  • Allow your child to ask questions and answer these questions truthfully. Your child may feel nervous or afraid. He or she may even cry. Let your child know that you’ll be nearby during the procedure.

  • Use play, if appropriate. With younger children, this can involve role-playing with a child’s favorite toy or object. With older children, it may help to read books about what happens during the procedure.