title: Pediatric urological laparoendoscopic single site surgery: single surgeon experience.
abstract: OBJECTIVE
  The aim was to assess the feasibility and outcomes of pediatric urological laparoendoscopic single site (LESS) surgery.
  
  
  METHODS
  A retrospective review was performed of all children who underwent LESS surgery at a single pediatric institution from September 2010 to July 2013. Patient demographics, intraoperative details, narcotic usage, and complications were reviewed. The umbilicus was used as the surgical site in all cases. All procedures were performed with a flexible tip laparoscope, a multichannel port, standard 3- or 5-mm laparoscopic instrumentation, and articulating instruments.
  
  
  RESULTS
  Sixty-one patients (50 male, 11 female) were identified. Procedures included 18 orchidopexies, 15 nephrectomies, 11 varicocelectomies, nine nephroureterectomies, four partial nephrectomies, one ureterectomy, one ureterolithotomy, one orchiectomy, and one utricle excision. The ureterolithotomy was converted to open surgery for failure to progress. The utricle excision was converted to conventional laparoscopy by adding one accessory port and one skin puncture because of the close proximity of the vas deferens to the utricle. Intraoperative complications included one vas deferens injury during orchidopexy in a postpubertal male. Postoperative complications occurred in six patients: five grade II and one grade IIIb.
  
  
  CONCLUSIONS
  Pediatric urological LESS procedures are technically feasible, safe, and effective. Further evaluation is warranted to better define its role in pediatric urological surgery.
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH 45229, USA.
authors.forename: Danesh
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 45229, USA.
authors.forename: Nicholas 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 45229, USA.
authors.forename: Christopher 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 45229, USA.
authors.forename: Eugene A
authors.initials: EA
authors.lastname: Minevich
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, ML 5037, Cincinnati, OH 45229, USA. Electronic address: paul.noh@cchmc.org.
authors.forename: Paul H
authors.initials: PH
authors.lastname: Noh
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009392:Nephrectomy / Q000379:methods; D056126:Orchiopexy / Q000379:methods; D012189:Retrospective Studies; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000379:methods*
keywords: Laparoendoscopic single site; Laparoscopy; Pediatric; Urological