Laparoscopic and robotic-assisted repair of retrocaval ureter in children: a multi-institutional comparative study with open repair.

Purpose: This retrospective study aimed to report a multi-institutional experience with laparoscopic and robotic-assisted repair of retrocaval ureter in children and to compare outcome of minimally invasive surgery (MIS) with open repair.

Methods: The records of all children, who underwent MIS and open repair of retrocaval ureters in six international pediatric urology units over a 5-year period, were retrospectively collected. Data were grouped according to the operative approach: a laparoscopic group (G1) included five patients, a robotic-assisted group (G2) included four patients, and an open group (G3) included three patients.

Minimal access surgery in the management of pediatric urolithiasis.

Background: In contrast to adult patients, a relatively large number of open surgical procedures are still needed in the treatment of urolithiasis in children. Since almost all open surgical techniques may be reproduced by minimal access surgery (MAS), there is a rationale to apply the latter in the management of pediatric urolithiasis. Our study aimed to assess the feasibility and outcome of MAS in the treatment of pediatric urinary calculi.

A comparison between laparoscopic and retroperitoneoscopic approach for partial nephrectomy in children with duplex kidney: a multicentric survey.

Purpose: To compare the outcome of laparoscopic and retroperitoneoscopic approach for partial nephrectomy in infants and children with duplex kidneys.

Methods: Data of 102 patients underwent partial nephrectomy in a 5-year period using MIS procedures were analyzed. Fifty-two children underwent laparoscopic partial nephrectomy (LPN), and 50 children underwent retroperitoneoscopic partial nephrectomy (RPN).

Retroperitoneoscopic Heminephrectomy in Duplex Kidney in Infants and Children: Results of a Multicentric Survey.

Purpose: Retroperitoneoscopic partial nephrectomy (RPN) in children is considered a complex technique with limited diffusion among pediatric surgeons and urologists. We aimed to report the outcome of this technique in infants and children with duplex kidney in a 5-year retrospective multicentric international survey.

Materials And Methods: Data on 50 children who underwent RPN (41 upper-pole nephrectomies and 9 lower-pole nephrectomies) were retrospectively collected in this six-institution survey.

Early thoracoscopic resection of an atypical upper extralobar sequestration.

We report a very rare case of complex upper extralobar pulmonary sequestration, detected during pregnancy and resected early because the diagnosis was uncertain (possibility of a teratoma). At 2 months, the upper left pulmonary lesion was completely removed by thoracoscopy. Pathology concluded an extralobar sequestration associated with a duplication cyst of mixed bronchogenic and esophageal type.

Minor hypospadias: the "tip of the iceberg" of the partial androgen insensitivity syndrome.

Background: Androgens are critical in male external genital development. Alterations in the androgen sensitivity pathway have been identified in severely undermasculinized boys, and mutations of the androgen receptor gene (AR) are usually found in partial or complete androgen insensitivity syndrome (AIS).

Objective: The aim of this study was to determine whether even the most minor forms of isolated hypospadias are associated with AR mutations and thus whether all types of hypospadias warrant molecular analysis of the AR.

Thirteen cases of isolated tubal torsions associated with hydrosalpinx in children and adolescents, proposal for conservative management: retrospective review and literature survey.

Background/purpose: Isolated tubal torsion associated with hydrosalpinx is a rare pathology. Our goal was to analyze the clinical and imaging features and discuss the different treatment options available.

Methods: We retrospectively reviewed all the cases of adnexal torsion treated in our department of pediatric surgery over a 10-year period.

Functional ectopic ureter in case of ureteric duplication in children: initial experience with laparoscopic low transperitoneal ureteroureterostomy.

Purpose: In this paper, we discuss the value of the laparoscopic ipsilateral ureteroureterostomy for duplication anomalies of the urinary tract in children.

Materials And Methods: A laparoscopic retroperitoneal ureteroureterostomy was undertaken in 2 children with 3-mm instruments and a 30-degree 5-mm optical trocar. Cystoscopy and stent placement in the recipient ureter was performed at the beginning of each procedure.

Minimal access surgery in the management of pediatric urolithiasis.

Purpose: In contrast to adult patients, a relatively large number of open surgical procedures are still needed in the treatment of urolithiasis in children. Since almost all open surgical techniques may be reproduced by minimal access surgery (MAS), there is a rationale to apply the latter in the management of pediatric urolithiasis. Our study aimed to assess the feasibility and outcome of MAS in the treatment of pediatric urinary calculi.

Adrenal masses in children: the role of minimally invasive surgery.

The development of laparoscopic surgery has extended its uses to include adrenalectomy in children and in adults. Because conventional adrenalectomy requires a large incision, minimally invasive surgery offers a less aggressive solution in some selected cases. Twenty-nine adrenal masses in 26 children were treated using adrenalectomy between 1994 and 2004 (12 were treated laparoscopically, the remaining 17 with open surgery).

Retroperitoneoscopic surgery in children.

Even if no large comparative studies enable us to definitely confirm the potential advantages of minimal retroperitoneoscopic access surgery, this new technique is now expanding in pediatric urology and considered today as feasible and safe in well-trained hands. The technique is described in detail; the main indications are presented from the classical ablative surgery, like total or partial nephrectomy, to more advanced reconstructive surgery, like pyeloplasty, retrocaval ureter, and stone disease. The success rate is similar to open surgery.

Laparoscopic resection of abdominal neuroblastoma.

Background: Since indications for laparoscopic adrenalectomy have progressively expanded to pediatric surgery, preliminary reports have studied the laparoscopic approach for abdominal neuroblastoma (NB). We aimed to report on the indications and the results of laparoscopic resection in a large series of abdominal NBs.

Methods: A retrospective multicenter study included 45 children with abdominal NBs (28 localized, 11 stage 4, 6 stage 4s) and laparoscopic resection of their abdominal primary tumor.

Thoracoscopic resection of neurogenic tumors in children.

Purpose: The aim of this study was to evaluate the feasibility of thoracoscopy in neurogenic tumors in infants and children.

Materials And Methods: From January 2000 to October 2005, 21 patients aged 7 months to 14 years (mean, 6 years) underwent thoracoscopy for tumor resection in 5 French institutions. One 10-mm optical port and 2 operative 5-mm ports were needed.

Laparoscopic versus open appendectomy in children: a retrospective comparative study of 2,332 cases.

Aim: The laparoscopic treatment of paediatric appendicitis remains controversial, especially in the presence of complications. This study evaluated the outcomes of open appendectomy (OA) and laparoscopic appendectomy (LA) by analysing the data from a multicentre study.

Methods: The authors retrospectively reviewed a series of 2,332 appendectomies (1,506 LA and 826 OA) performed in children and adolescents (median age 8 years) in 9 different centres of paediatric surgery.

[Vesicoureteric reflux in children: long-term results of endoscopic treatment by Macroplastique injection].

Objective: To evaluate the long-term efficacy (from the fifth year after injection and up to seven years) of endoscopic treatment by Macroplastique implant for vesicoureteric reflux (VUR) in children, sometimes associated with urological malformations or renal complications. The secondary objective was to evaluate the local tolerance of the Macroplastique implant and the development of any local (haematuria, stones, ureteric stasis) or distant complications.

Material And Methods: Retrospective analysis of the medical files of 389 patients, representing a total of 590 refluxing ureters treated by Macroplastique injection in eight different centres.

Retroperitoneal minimally invasive endoscopic adrenalectomy in children.

Conventional adrenalectomy for tumor excision is one of the challenging tasks in adults as well as children with mounted postoperative complications. Advancing laparoscopic techniques with the new era of diagnostic image developments aids this kind of procedure performed mainly in adults with only few reports in children. Here we present a review of this considerably new approach in children, adrenalectomy achieved through endoscopic retroperitoneal minimally invasive technique, discussing the indications, the advantages and disadvantages, and a comparison between this approach and other endoscopic techniques performed for this type of surgery.

Treatment of ureterocele on duplex ureter: upper pole nephrectomy by retroperitoneoscopy in children based on a series of 24 cases.

Objective: The objective of this study is to present the results of a preliminary series of 24 upper pole nephrectomies performed by retroperitoneoscopy in children between 1995 and 2000.

Material And Methods: The patient was placed in the lateral supine position and 3-4 trocars were inserted. Parenchymal section was performed by ultrasound or unipolar scalpel.

[Treatment of ureterocele in ureteral duplication: upper pole nephro-ureterectomy by retroperitoneoscopy in children: 24 cases].

Objective: The objective of this study is to present the results of 24 upper pole nephrectomies performed by retroperitoneoscopy in children between 1995 and 2000.

Material And Methods: This series of 24 children consisted of 15 girls and 9 boys with a mean age of 22 months. The patient was placed in the lateral supine position and 3 to 4 trocars were inserted.