LigaSure in laparoscopic transperitoneal heminephroureterectomy in children: a comparative study.
BACKGROUND
This study was conducted to evaluate the feasibility of using the LigaSure vessel sealing system (Valleylab, Boulder, CO) in laparoscopic transperitoneal vs. open retroperitoneal heminephroureterectomy in children.


METHODS
Seven consecutive patients with impaired renal duplex systems underwent laparoscopic heminephroureterectomies using LigaSure between April 2003 and April 2005. The operative time, complications, and hospital stay were analyzed prospectively. The data of 7 consecutive patients who had undergone open retroperitoneal heminephroureterectomy from 2001 to 2003 were analyzed for comparison purposes. The mean ages, underlying disease, and location of the affected kidney pole were not significantly different between these groups.


RESULTS
There were no intraoperative complications during laparoscopic heminephroureterectomy and all procedures were completed laparoscopically. The mean operative time of 144 minutes (range, 90-210 minutes) for laparoscopic heminephroureterectomy was somewhat longer than in open heminephroureterectomy-mean time 110 minutes (range, 60-165 minutes) (P = 0.5). Complications of open retroperitoneal heminephroureterectomy included bleeding of the surface of the remaining kidney pole in one patient, requiring extensive hemostatic suturing. Postoperative recovery was uneventful in all laparoscopic procedures, whereas intermittent retention of urine was noticed in one patient undergoing the open procedure.


CONCLUSIONS
Laparoscopic heminephroureterectomy using LigaSure is feasible in children and has a similar operative time compared to conventional heminephroureterectomy.
Metzelder
Martin L
ML
Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany. mmetzelder@yahoo.com
Kübler
Joachim F
JF
Nustede
Rainer
R
Ure
Benno M
BM
D002648:Child; D002675:Child, Preschool; D004564:Electrocoagulation / Q000295:instrumentation; D005240:Feasibility Studies; D005260:Female; D006489:Hemostatic Techniques / Q000295:instrumentation; D006801:Humans; D007223:Infant; D010535:Laparoscopy; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D010537:Peritoneum; D011446:Prospective Studies; D014513:Ureter / Q000601:surgery*