V11-08: Laparoendoscopic Single-Site Surgery (LESS) Nephrectomy for Multicystic Dysplastic kidney of a Child
VideoIntroductions and Objectives
LESS has been reported as an evolving minimally invasive option for treatment of various adult urologic diseases. However, the role of LESS in treatment of pediatric urologic diseases is still not well confirmed. We present a video that shows the technique of LESS nephrectomy for multicystic dysplastic kidney of a child.
In this video we present 9 years old boy that presented with recurrent right flank pain. His ultrasound showed multiple right renal cysts. His computed tomography of the abdomen and pelvis confirmed the diagnosis of right multicystic dysplastic kidney. LESS right nephrectomy was done using Covedien port that was inserted through 2.5 cm skin incision through the umbilicus. Both straight and articulating instruments were used. Because of the huge size of the right kidney, initially a large lower polar cyst was drained. The atrophic right renal pedicle was identified, dissected and clipped en-bloc using hem-O-clips. One 5-mm port was added through the same skin incision, but through a different fascial plane to allow retraction of the liver at the time of clipping of renal pedicle. The specimen was retrieved through 3-cm skin incision.
Operative time was 160 minutes. There was no conversion to open surgery or conventional laparoscopy. There were no intraoperative or postoperative complications. Blood loss was 50 c.c. The child was discharged from the hospital after 1 day. Follow-up of the child for 9 months showed clinical cure and invisible umbilical scar.
LESS nephrectomy is a technically feasible, safe and effective option for treatment of multicystic dysplastic kidney of pediatrics.