Advances in Pediatric Surgery: Minimally Invasive Approaches and Long-Term Outcomes

Abstract

Minimally invasive surgery (MIS) has become central to pediatric surgical practice over the last three decades. Laparoscopy, thoracoscopy, and robotic assistance are increasingly standard in procedures once confined to open approaches. Evidence consistently shows MIS reduces postoperative pain, hospital stay, and wound complications, while offering superior cosmetic outcomes. More importantly, growing data confirm that long-term functional outcomes are comparable or superior to open surgery, including musculoskeletal development, fertility, and quality of life. Neonatal adaptations, the integration of Enhanced Recovery After Surgery (ERAS) protocols, and robotic platforms have expanded the scope of MIS. However, concerns persist around costs, training, and equitable access across health systems. This editorial argues that pediatric MIS must be judged not only by perioperative recovery but also by durable outcomes into adolescence and adulthood. With robust outcome reporting, structured training, and selective technology use, MIS can deliver on its promise of long-term benefit for children worldwide.