title: Laparoendoscopic single-site surgery (LESS) for major urological procedures in the pediatric population: A systematic review.
abstract: BACKGROUND
  Improvements in laparoscopic surgery have led to the introduction of laparoendoscopic single-site surgery (LESS) as an alternative to conventional laparoscopy conferring a number of possible advantages. In this review, we aim to elucidate the aspects of LESS for major urological procedures in the pediatric population.
  
  
  METHODS
  An in-depth search of the literature was performed in the databases of PubMed and Scopus, for studies investigating the technical aspects and clinical outcomes of partial nephrectomies, nephrectomies, nephroureterectomies, varicocelectomies and pyeloplasties in children. Data on parameters such as operation time, instrumentation, perioperative complications, hospital stay and follow up period were collected and further analyzed cumulatively.
  
  
  RESULTS
  Twenty nine studies met the inclusion criteria incorporating 386 patients who underwent 401 procedures. There were no major intraoperative complications, with only 19 patients (4.73%) facing postoperative complications. No perioperative deaths were reported.
  
  
  CONCLUSIONS
  In the hands of experienced surgeons LESS seems a feasible, efficient and less invasive alternative to standard laparoscopy in the field of pediatric urology. There is an eminent need of well-designed randomized controlled trials comparing the two techniques.
authors.affiliation: 2nd Department of Urology, Aristotle University of Thessaloniki, Greece; Surgery Working Group, Society of Junior Doctors, Athens, Greece.
authors.forename: Evangelos N
authors.initials: EN
authors.lastname: Symeonidis
authors.affiliation: Surgery Working Group, Society of Junior Doctors, Athens, Greece.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Nasioudis
authors.affiliation: Surgery Working Group, Society of Junior Doctors, Athens, Greece; Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. Electronic address: keconomopoulos@mgh.harvard.edu.
authors.forename: Konstantinos P
authors.initials: KP
authors.lastname: Economopoulos
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D007668:Kidney / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D009392:Nephrectomy / Q000379:methods; D061646:Operative Time; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000379:methods; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery; D014570:Urologic Diseases / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*
keywords: LESS; Laparoscopy; Pediatrics; Surgery; Urology