V547: Laparoendoscopic single-site pyeloplasty: Compared LESS pyeloplasty with conventional laparoscopic procedure
VideoIntroduction and Objectives
Laparoendoscopic single-site surgery (LESS) for pediatric patients has been reported from some institutions._x000D_ We have quickly applied this procedure for pyeloplasty to treat patients with hydronephrosis.
A total of 18 LESS pyeloplasty cases performed in our clinic since 2008 were entered in this study.We compared LESS pyeloplasty with conventional laparoscopic procedure using age-matched cohort of patients.After making a 12-15mm umbilical vertical incision, a LESS specific port, Triport ®that has two 5-mm and one 10-mm working ports and a gas insufflation channel, was indwelled. A 5mm flexible scope was utilized as an optical visual tube, and 5-mm forceps with a flexible tip and regular laparoscopic devices were used.
The mean age of the patients was 20.3 years (range1-56 years). LESS pyeloplasty was performed on the right in 8 cases and on the left in 10 cases. The operative time was 255±74 minutes (mean±SD). Regarding the nine pediatric patients, the mean age of the patients was 4.8 years (range1-10 years). The operative time was 253±47 minutes. As for the nine adult patients, the mean age of the patients was 35.7 years (range16-56 years).The operative time was 257±93 minutes. Mean operative time of the control group, an age-matched laparoscopic pyeloplasty (18 cases) was 246±62 minutes. It was 221±56 minutes for the pediatric patients (9 cases) and 241±81 minutes for the adult patients (9 cases). There was no significant difference in the operative time between the control group and the LESS group for both adults and children. Blood loss was minimal and no intraoperative and postoperative complications were observed in the 18 LESS pyeloplasty cases. Oral intake started 1.5 days after operation. The pain scale (Max: 5) reached 2.7, the highest, on Day 0 post operation, then became 2.0 on Day 1, 1.6 on Day 2 and 0.1 on Day 4.
LESS for pediatric patients has just begun, and the number of experience is still small. This procedure demonstrated its less invasiveness and is feasible for pediatric patients as well as adults. Being cosmetically highly favorable, in the future, this procedure will likely to be further distributed.