title: Umbilical only access laparoscopic pyeloplasty in children: Preliminary report.
abstract: BACKGROUND
  Over the past three decades, laparoscopic surgery has become a well-established alternative to open surgery in the management of ureteropelvic junction (UPJ) obstruction. Currently, several efforts are being made, aimed at further reducing the morbidity associated with conventional laparoscopy. We report our experience with modified umbilical port laparoscopic pyeloplasty in children.
  
  
  METHODS
  Children presenting with hydronephrosis secondary to UPJ obstruction formed the study group. A 5 mm endoscopic port was placed on the inferior umbilical crease. The two 3 mm instruments were introduced through puncture sites created a few mm superior and lateral to the endoscopic port, under vision. Total operating time, the time taken for insertion of double pigtail catheter, time taken for pyeloplasty anastomosis and complications were noted.
  
  
  RESULTS
  During the study period, 16 children underwent modified umbilical only access laparoscopic pyeloplasty. The total operating time and the time for insertion of double pigtail catheter were significantly more in our earlier half of cases.
  
  
  CONCLUSIONS
  Modified umbilical port laparoscopic pyeloplasty reduces the morbidity associated with conventional multiport laparoscopy without the need of expensive multichannel cannulas, curved laparoscopic instruments and longer laparoscopic endoscopes. Though crossing instruments are a factor which prolongs the duration of surgery, it does not hinder complex suturing needed during pyeloplasty.
authors.affiliation: Department of Urology, KLE University's - JN Medical College, KLES Dr. Prabhakar Kore Hospital and MRC, Belagavi - 590 010, Karnataka, India.
authors.forename: Rajendra B
authors.initials: RB
authors.lastname: Nerli
authors.affiliation: Department of Urology, KLE University's - JN Medical College, KLES Dr. Prabhakar Kore Hospital and MRC, Belagavi - 590 010, Karnataka, India.
authors.forename: Prasad V
authors.initials: PV
authors.lastname: Magdum
authors.affiliation: PG Department of Studies in Biotechnology and Microbiology, Karnatak University, Dharwad, Karnataka, India.
authors.forename: Shridhar C
authors.initials: SC
authors.lastname: Ghagane
authors.affiliation: PG Department of Studies in Biotechnology and Microbiology, Karnatak University, Dharwad, Karnataka, India.
authors.forename: Murigendra B
authors.initials: MB
authors.lastname: Hiremath
authors.affiliation: Department of Urology, KLE University's - JN Medical College, KLES Dr. Prabhakar Kore Hospital and MRC, Belagavi - 590 010, Karnataka, India.
authors.forename: Mallikarjuna
authors.initials: M
authors.lastname: Reddy
mesh_terms: D002648:Child; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology / Q000601:surgery; D007682:Kidney Pelvis / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D014472:Umbilicus / Q000601:surgery; D014517:Ureteral Obstruction / Q000209:etiology / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods*