Background:Laparoscopic renal surgery is an effective treatment for nonfunctioning renal units, although its role in the very young is still largely undetermined. Our objective was to evaluate the efficacy and safety in a large series of laparoscopic procedures done in young children whom underwent nephrectomies or partial nephrectomies.
Methods:41 laparoscopic procedures were performed in children less than 2 years (26 less than 1). The diagnosis were hydronephrosis in 7, multicystic/dysplastic kidneys in 6, nonfunctioning upper poles in 17 (2 upper pole UPJ obstruction, ectopic ureters with or without ureteroceles in 4 and 11), non functioning lower poles in 4 or miscellaneous in 7.
Results:20 total and 21 partial nephrectomies (17 upper, 4 lower) were performed laparoscopically in 23 females and 18 males. Mean age and weight were 9.89 months (2-23 months) and 8.47 kg (4-13.7 kg). 23 procedures were done transperitoneally vs. 18 retroperitoneally. Three ports (3-5 mm) were used in all except 2 (4 ports). The mean operative duration was 160 minutes. There were no intra-operative complications (surgical and anesthetic) including no transfusion. 7 cases done retroperitoneally were converted due to technical challenges (port leakage, poor visibility, peritoneal tear). The mean hospital stay was 2.15 days. Postoperative complications included an omental hernia and a urinoma.
Conclusions:Laparoscopic renal surgery can be carried out safely and effectively in young children and may avoid the morbidity of an open procedure. Transperitoneal approach or retroperitoneoscopy can be done but the latter approach is more challenging in a very young population.

Back to Final Program