Umbilical only access laparoscopic pyeloplasty in children: Preliminary report

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 lapar...

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Published in:African journal of paediatric surgery 2016-01, Vol.13 (1), p.36-40
Main Authors: Nerli, Rajendra, Magdum, Prasad, Ghagane, Shridhar, Hiremath, Murigendra, Reddy, Mallikarjuna
Format: Article
Language:English
Subjects:
Child
Female
Humans
Hydronephrosis - etiology
Hydronephrosis - surgery
Kidney Pelvis - surgery
Laparoscopy
Laparoscopy - methods
Male
Original
Patient outcomes
Pediatric surgery
Physiological aspects
ports
pyeloplasty
Umbilical cord
Umbilicus - surgery
Ureteral Obstruction - etiology
Ureteral Obstruction - surgery
ureteropelvic junction obstruction
Urologic Surgical Procedures - methods
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Summary: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. Materials and 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.
ISSN:0189-6725
0974-5998
DOI:10.4103/0189-6725.181705