Early Experience with Laparoendoscopic single-site pyeloplasty in Children

Objective: To present our initial clinical experience with laparoendoscopic single-site surgery (LESS) for ureteropelvic junction obstruction (UPJO) in the pediatric age group. Material and methods: Between January and December 2009, 11 consecutive pediatric patients underwent treatment of primary UPJO via a laparoscopic approach. All patients underwent LESS-pyeloplasty. Radiographic success was defined as improvement of hydronephrosis with a patent UPJ on intravenous urography, or improved drainage on diuretic renal scan. Results: The mean age of patients was 10 (2-17) years. Crossing lower pole vessel and severe adhesion were found in three (27%) and eight (73%) cases, respectively. The mean operating-room time was 182.5 (160-300) min, and the mean estimated blood loss, including urine, was 97.3 (80-160) mL. Mean hospital stay was 2 (1-3) days. Wound infection at port site and urinary infection occurred in one case each. All parents seem extremely satisfied with postoperative cosmetic outcome. The success rate was 100%. Conclusion: Preliminary experience with LESS-pyeloplasty in children suggests that outcomes are comparable to conventional laparoscopic surgery but with improved cosmesis; however, a larger study is necessary to confirm these findings and to determine if there are any benefits in postoperative pain or recovery. (C) 2010 Journal of Pediatric Urology Company. Published by Elsevier Ltd. All rights reserved.