title: Laparoendoscopic single-site (LESS) bilateral nephrectomy in the pretransplant pediatric population.
abstract: End-stage renal failure management in children may require bilateral kidney removal prior to transplantation secondary to recurrent urinary tract infections, renin-dependent hypertension, vesicoureteral reflux, proteinuria, risk of malignancy (Denys-Drash), or high output renal failure. Conventional laparoscopy or open nephrectomy has been employed to date. However, we present our method of bilateral nephrectomy in four patients via the SILS Covidien © system. Patient age ranged from 18 months to 18 years. Operative time ranged from 308 to 370 minutes. Estimated blood loss was minimal, all cases were completed via the single incision and no cases were converted to open. Laparoendoscopic single-site bilateral nephrectomy is safe and feasible in children and well-suited for the pre-transplant population.
authors.affiliation: LESS Bilateral Nephrectomy in Children, Division of Urology and Rady Children's Hospital, University of California, San Diego, CA, USA. smarietti@rchsd.org
authors.forename: Sarah
authors.initials: S
authors.lastname: Marietti
authors.forename: Nicholas
authors.initials: N
authors.lastname: Holmes
authors.forename: George
authors.initials: G
authors.lastname: Chiang
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006084:Graft Rejection; D006085:Graft Survival; D006801:Humans; D007223:Infant; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000601:surgery*; D016030:Kidney Transplantation / Q000009:adverse effects / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000503:physiopathology; D011183:Postoperative Complications / Q000503:physiopathology; D011300:Preoperative Care / Q000379:methods; D018570:Risk Assessment; D012494:Sampling Studies; D016896:Treatment Outcome; D014472:Umbilicus / Q000601:surgery