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Objectives: To report the surgical technique and the early outcomes of nephrectomy and heminephroureterectomy by single-incision laparoscopic surgery (SILS) in children using conventional laparoscopic instruments only.
Methods: Three consecutive children (aged 3, 4 and 7 years) who underwent nephrectomy for multicystic dysplastic kidney (n = 2) and upper moiety heminephroureterectomy for duplex kidney (n = 1) by SILS were retrospectively reviewed. A standardized infraumbilical incision was used for the insertion of 3 reusable ports of 3 and 5 mm. The SILS procedure was performed by the technique of crossing 2 straight instruments.
Results: All 3 procedures were successfully performed by SILS without any intraoperative complications or need for conversion. The 2 nephrectomies were each completed in 120 minutes, whereas the heminephroureterectomy took 400 minutes. Only 1 dose of narcotic analgesic was required by 1 patient, and 2-6 doses of oral acetaminophen were taken for postoperative pain control. All 3 children recovered smoothly from surgery without complications.
Conclusions: Nephrectomy and heminephroureterectomy by SILS using conventional instruments are technically feasible in young children. Further studies are required to investigate whether the SILS approach can become a sound alternative to standard laparoscopy.
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| http://dx.doi.org/10.1016/j.urology.2010.07.474 | DOI Listing |
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