title: Pediatric laparo-endoscopic single site partial nephrectomy: feasibility in infants and small children for upper urinary tract duplication anomalies.
abstract: OBJECTIVE
  To assess the feasibility and outcomes of laparo-endoscopic single site (LESS) partial nephrectomy (PN) in infants and small children for upper urinary tract duplication anomalies.
  
  
  METHODS
  The medical records of all patients undergoing LESS PN at a single pediatric institution were retrospectively reviewed for patient demographics, perioperative details, and outcomes. A cystoscopy was initially performed to place an externalized catheter into the ureter of the ipsilateral normal renal moiety. An Olympus TriPort, an Olympus Endoeye flexible tip laparoscope, standard 3- or 5-mm instrumentation, and a LigaSure Blunt were utilized.
  
  
  RESULTS
  Four children (two boys, two girls) underwent LESS PN. Three patients underwent upper pole PN and one underwent lower pole PN. All procedures were performed for poorly functioning obstructed renal moieties (one ureterocele, one ureteropelvic junction obstruction and vesicoureteral reflux, and two ectopic ureters). Median age was 6.2 months (range 2.5-16.4 months). Median weight was 7.7 kg (range 6.1-12.6 kg). Median operative time was 126 min (range 97-180 min). No patient received inpatient postoperative narcotics. Median follow-up was 9.9 months (range 6.2-19.1 months). No postoperative complications were noted. Postoperative renal ultrasound demonstrated successful resection in all patients.
  
  
  CONCLUSIONS
  LESS PN is technically feasible, safe, and effective for upper urinary tract duplication anomalies in infants and small children.
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH, USA.
authors.forename: D
authors.initials: D
authors.lastname: Bansal
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH, USA.
authors.forename: N G
authors.initials: NG
authors.lastname: Cost
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH, USA.
authors.forename: C M
authors.initials: CM
authors.lastname: Bean
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH, USA. Electronic address: paul.noh@cchmc.org.
authors.forename: P H
authors.initials: PH
authors.lastname: Noh
mesh_terms: D000367:Age Factors; D002675:Child, Preschool; D003558:Cystoscopy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009392:Nephrectomy / Q000379:methods*; D061646:Operative Time; D012189:Retrospective Studies; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D014518:Ureterocele / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D014551:Urinary Tract / Q000002:abnormalities*; D014718:Vesico-Ureteral Reflux / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*
keywords: Hydroureteronephrosis; Laparoendoscopic single site; Minimally invasive surgery; Partial nephrectomy; Pediatrics; Upper urinary tract duplication