A two-center experience with the exclusive use of laparoscopic transperitoneal nephrectomy for benign renal disease in children

Abstract

Transperitoneal laparoscopic nephrectomy is technically feasible in most cases of benign renal disease. The intraoperative complications are minimal, and recovery for most is robust. Two-thirds of the patients are discharged within 24 h. In this study, narcotic analgesics were prescribed in about a one-third of all the cases for a limited period. Further problems may be seen when refluxing ureters are incompletely excised. However, the transperitoneal approach does not mitigate against complete excision because the exposure to the pelvis is adequate. At the midterm follow-up assessment, adhesive obstruction was not encountered, confirming this approach as a tenable alternative to other laparoscopic approaches for nephrectomy.

Laparoscopic nephroureterectomy for Wilms' tumor: Oncologic considerations

“…From a technical standpoint, a nephrectomy can be achieved laparoscopically with minimal complications to surrounding structures. With the advent of minimally invasive surgical techniques for benign renal disease in children, surgeons are becoming increasingly familiar with this approach, and multiple reports have established minimally invasive surgery as a reasonable approach with clinical benefit [4][5][6][7]. In using such techniques, our case demonstrates that a minimally invasive approach can be applied to the treatment of Wilms' tumor.…”

“…There have been no reported complications, and tumor rupture has not occurred. In addition, there are preliminary but encouraging data that a laparoscopic approach to nephrectomy in benign disease is associated with decreased lengths of stay and analgesic requirements in the pediatric patient [4][5][6][7]. In the child with cancer, there is an added theoretical benefit in that a laparoscopic approach may hasten recovery and thereby reduce the time required to begin or reinstitute chemo-or radiotherapy postoperatively.…”

Transumbilical Multiport Laparoscopic Nephroureterectomy for Congenital Renal Dysplasia in Children: Midterm Follow-Up from a Single Institution

“…Both the transperitoneal and retroperitoneal approaches have been described for laparoscopic nephrectomy or nephroureterectomy. However, for pediatric surgeons familiar with the layout of abdominal cavity, the laparoscopic transperitoneal approach represents a natural progression from performing laparotomies (10). …”

Single Port Paediatric Heminephrouretectomy

“…In common with our previous experience of transperitoneal laparoscopic heminephrectomy and in contrast to some authors' descriptions, splenic mobilisation was not necessary to dissect the upper pole. 7,8,18 This reduces the risk of splenic injury. This procedure was accomplished in a slightly longer operative time than our previous experience with transperitoneal laparoscopic heminephrectomy.…”