LAPAROSCOPIC RENAL SURGERY VIA A RETROPERITONEAL APPROACH IN CHILDREN

Abstract

No AccessJournal of UrologyLaparoscopy1 Sep 1998LAPAROSCOPIC RENAL SURGERY VIA A RETROPERITONEAL APPROACH IN CHILDREN ALAA EL-GHONEIMI, JEAN S. VALLA, HENRI STEYAERT, and YVES AIGRAIN ALAA EL-GHONEIMIALAA EL-GHONEIMI More articles by this author , JEAN S. VALLAJEAN S. VALLA More articles by this author , HENRI STEYAERTHENRI STEYAERT More articles by this author , and YVES AIGRAINYVES AIGRAIN More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)62719-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Laparoscopic procedures are still not widely performed by pediatric urologists due to operative time and costs as well as the lack of indications and, thus, the lack of sufficient surgeon experience. We report our experience with the retroperitoneal approach using special inexpensive methods for various indications in children. Materials and Methods: From 1994 to 1997 we performed 42 retroperitoneal laparoscopic procedures in 41 children with a mean age of 4 years, including 31 nephrectomies, 8 partial nephrectomies, 2 renal cystectomies and 1 pyelolithotomy. A total of 13 patients were younger than 1 year. Followup ranged from 6 months to 3 years. Results: Mean operative time was 104 minutes (range 35 to 150) for nephrectomy, 153 (range 90 to 210) for upper pole nephroureterectomy, 135 for pyelolithotomy and 60 for renal cystectomy. Average postoperative stay was 2 days. Conversion was required in 2 cases of partial nephrectomy due to unidentified polar vessels, including 1 involving duodenal perforation. Conclusions: The indications for retroperitoneal laparoscopy are expanding with the experience of the surgical team. The retroperitoneal approach provides a technique comparable to that of conventional renal surgery. References 1 : Pediatric laparoscopy: prudence please. J. Urol.1994; 151: 742. Link, Google Scholar 2 : Laparoscopic nephrectomy: initial case report. J. Urol.1991; 146: 278. Link, Google Scholar 3 : Laparoscopic nephrectomy in a child: expanding horizons for laparoscopy in pediatric urology. J. Endourol.1992; 6: 463. Google Scholar 4 : Laparoscopic nephroureterectomy for end-stage reflux nephropathy in a child. Surg. Laparosc. Endosc.1993; 3: 462. Google Scholar 5 : Laparoscopic renal surgery in children. J. Urol.1994; 151: 735. Link, Google Scholar 6 : Retroperitoneal endoscopy. J. Med. Primatol.1976; 5: 124. Google Scholar 7 : Laparoscopic operative retroperitoneoscopy: use of a new devise. J. Urol.1992; 148: 1137. Link, Google Scholar 8 : Retroperitoneal nephrectomy: comparison of laparoscopy with open surgery. World J. Surg.1996; 20: 713. Google Scholar 9 : Laparoscopic versus lumboscopic nephrectomy. Eur. Urol.1996; 29: 288. Google Scholar 10 : Retroperitoneal laparoscopic nephrectomy in children. Preliminary report of 18 cases. Eur. Urol.1996; 30: 490. Google Scholar 11 : Complications of laparoscopic nephrectomy in 185 patients: a multi-institutional review. J. Urol.1995; 154: 479. Link, Google Scholar 12 : Complications in pediatric urological laparoscopy: results of a survey. J. Urol.1996; 155: 1070. Link, Google Scholar 13 : Complications of extraperitoneal balloon dilation. J. Endourol.1996; 10: 375. Google Scholar 14 : Retroperitoneal laparoscopic nephrectomy: animal and human anatomic studies. J. Endourol.1995; 9: 487. Google Scholar 15 : The extraperitoneal approach and subcutaneous emphysema are associated with greater absorption of carbon dioxide during laparoscopic renal surgery. J. Urol.1995; 154: 959. Link, Google Scholar 16 : Laparoscopic pyelolithotomy. Urology1997; 49: 131. Google Scholar 17 : Laparoscopic upper pole partial nephrectomy with ureterectomy. J. Urol.1993; 150: 940. Link, Google Scholar 18 : Laparoscopic heminephroureterectomy in pediatric patients. J. Urol.1997; 158: 1928. Link, Google Scholar From the Departments of Pediatric Surgery and Urology,