Pediatric laparoendoscopic single-site partial nephrectomy: initial report

Objectives: We present a case of transumbilical laparoendoscopic single-site surgery (LESS) for partial nephrectomy in a child.

Methods: On May 22, 2009, we performed LESS partial nephrectomy on a 7-year-old girl with a 3.5-cm renal mass. The surgery was performed using a homemade single-port device inserted through a single 3-cm umbilical incision. LESS partial nephrectomy was performed with hilar clamping and suturing of the renal defect.

Results: The duration of the operation was 210 minutes, and the warm ischemic time was 42 minutes. The suturing required 35 minutes, and the estimated blood loss was 10 mL. Histopathological analysis revealed a 3.5-cm metanephric adenoma with a clean surgical margin. The patient was discharged without intraoperative or postoperative complications. On follow-up, Doppler ultrasound sonography showed the kidney was normal in appearance, size, and echogenicity. Split renal function was calculated to be 47.5% for the left kidney upon dimercaptosuccinic acid renal scintigraphy.

Conclusions: LESS partial nephrectomy was safe and feasible for removal of a renal mass in a child. Additional development of applicable instruments and refinement of the suturing technique are needed.