title: Laparoendoscopic single-site urologic surgery in children less than 5 years of age.
abstract: OBJECTIVE
  We report our experience with laparoendoscopic single-site (LESS) urological procedures in children less than 5 years of age.
  
  
  METHODS
  Ten patients (11 procedures) underwent LESS through the umbilicus. Seven patients underwent nephrectomy and three patients underwent pyeloplasty (one simultaneous bilateral). R-port port (Advanced Surgical Concepts, Ireland) was used in nine cases, in one case, the Gelpoint access port (Applied Medical, Rancho Santa Margarita, CA, USA) was used. The Olympus Endoeye camera with coaxial light cable was used. The hilum was secured in all cases with Hem-o-Lok clips (Teleflex Medical, Research Triangle Park, NC, USA) except in one case in which an Endo GIA stapler (Covidien Surgical, Norwalk, CT, USA) was used.
  
  
  RESULTS
  All procedures were technically successful. Accessory port (3 mm) was used in 3 patients. Mean age in nephrectomized patients was 3.14±1.7 years, the mean operative room time (ORT) was 97.5±12.54 minutes. In the pyeloplasty group, mean ORT was 192±47.16 minutes and mean age was 2.43±2.3 years. Bilateral pyeloplasty was done in a 4-month-old infant. The ORT in this case was 180 minutes. A follow-up renogram done in the pyeloplasty patients (n=2) showed good drainage. Mean length of stay was 3.6 days (range, 3 to 6 days).The analgesic requirement was 23.86 mg (range, 12.5 to 50 mg) of diclofenac sodium.
  
  
  CONCLUSIONS
  LESS is technically feasible in patients as young as 4 months of age. It has the potential to offer better cosmesis. This needs to be proved in further comparative studies. Development of miniature instruments will further the growth of LESS in this age group.
authors: Department of Urology, Muljibhai Patel Urological Hospital, Gujarat, India.
authors: Arvind
authors: A
authors: Ganpule
authors: Chetan
authors: C
authors: Sheladiya
authors: Shashikant
authors: S
authors: Mishra
authors: Ravindra
authors: R
authors: Sabnis
authors: Mahesh
authors: M
authors: Desai
keywords: Laproscopy; Nephrectomy; Pyeloplasty
references: J Urol. 2007 Oct;178(4 Pt 2):1579-83
references: 17707047
references: Eur Urol. 2009 May;55(5):1198-204
references: 18715694
references: J Urol. 2000 Mar;163(3):937-9
references: 10688024
references: J Urol. 1996 Mar;155(3):1070-3
references: 8583567
references: J Pediatr Urol. 2011 Apr;7(2):187-91
references: 21131232
references: Surg Endosc. 2009 Aug;23(8):1894-9
references: 19430837
references: Urology. 2008 Aug;72(2):260-3; discussion 263-4
references: 18468664
references: J Urol. 2010 Mar;183(3):1163-7
references: 20096869
references: J Endourol. 2007 Dec;21(12):1461-6
references: 18186684
references: Cleft Palate Craniofac J. 1994 Nov;31(6):429-36
references: 7833334
references: Urology. 2010 Dec;76(6):1457-61
references: 20970837
references: J Minim Access Surg. 2011 Jan;7(1):96-8
references: 21197252