Objective: Heminephrectomy in the pediatric population remains a popular open surgical procedure. We describe our experience with laparoscopic heminephrectomy using a retroperitoneoscopic approach.
Materials and methods: Data were collected retrospectively and prospectively on all patients undergoing laparoscopic heminephrectomy by a single surgeon using a prone retroperitoneoscopic approach. Information relating to the age, sex, laterality, duration of surgery, analgesic requirements, duration of hospital stay, postoperative complications and outcome was recorded.
Results: Between March 2001 and August 2005 54 laparoscopic heminephrectomies were performed in 48 children (34 girls and 14 boys). The median age at surgery was 14 months (range 2-112 months). Forty-four upper and 10 lower moieties were removed. The median operative time was 105 min (range 50-150 min). There were no intraoperative complications and no conversions. There were four minor complications, comprising haematuria (n=1) and postoperative pyrexia (n=3). The median length of follow up was 22 months (range 3-57 months). All patients remained asymptomatic at last follow up. Ultrasound findings included presence of a visible ureteric stump (n=7) and cysts at the resection margin of the remaining remnant (n=17); none of these patients manifested clinical symptoms (e.g. infection, pain).
Conclusions: With advanced laparoscopic skills, laparoscopic heminephrectomy is a feasible operation for the treatment of non-functioning duplex renal units in children and infants.