Laparoendoscopic Single-Site Surgery for Pediatric Urologic Disease

Background: Laparoendoscopic single-site surgery (LESS) was performed for 31 cases of pediatric urologic disease in our department. Objective: A retrospective chart review was performed on pediatric patients who underwent LESS. Design, Setting, and Participants: Procedures included pyeloplasty (21), nephrectomy (4), varicocele ligation (3), orchiectomy (1), orchiopexy (1), and removal of female genitalia (1). In all 31 cases, an incision of 15 to 20mm was made in the umbilical region, and a port for LESS was put in place. A 5-mm flexible scope and 5-mm forceps with a bending tip and regular laparoscopic forceps (3, 5mm) were used. Outcome Measurements and Statistical Analysis: Intraoperative and postoperative outcomes were evaluated. Results and Limitations: For the 21 patients with pyeloplasty, the mean operation time was 240 minutes. Postoperative renal pelvis dilatation was relieved in all patients. For the 4 patients with nephrectomy, the mean operation time was 128 minutes. Postoperative urinary incontinence disappeared in all patients. The mean operation time of varicocele ligation was 73 minutes. Postoperation, varicocele disappeared and there was no testicular atrophy. The operation times of orchidectomy, bilateral orchidopexy, and removal of female genitalia mutilation were 60, 170, and 189 minutes, respectively. In all cases, there were no intraoperative or postoperative complications. Conclusions: The advantages of LESS include superior aesthetics with a smaller scar and less pain. LESS is considered as a less burdensome surgery for pediatric patients.