Single incision laparoscopic heminephroureterectomy in the management of ureteral duplication in children

Abstract

Objectives: We present our technique and results of single incision laparoscopic heminephroureterectomy (SILH) in the management of ureteral duplication (UD) in children. Methods: Medical records of all patients with UD undergoing SILH in our center from July 2018 to March 2023 were reviewed. For SILH, a single 15 mm umbilical skin incision was made and two 6 mm ports and one 4 mm port were placed at different points at the same incision. Conventional 3–5 mm straight laparoscopic instruments were used without any abdominal drain. Results: 8 children (6 girls and 2 boys, aged 3–45 months) with symptomatic UD were enrolled. Five patients had UD on the left and three on the right side. The operative duration was 100 - 140 min. There was no need for an additional port or conversion to open surgery and no intraoperative complications. All the patients recovered well, resumed oral feeding on POD 1 day, and were discharged on POD 3–6. At a follow-up of 8 – 30 months, all patients were asymptomatic. Postoperative cosmesis was excellent as all patients were virtually scarless. Conclusions: Our technique of SILH with conventional laparoscopic instruments for ureteral duplication in children is feasible, safe, with excellent cosmesis.

Keywords

• Single incision
• Laparoscopic surgery
• Heminephrectomy
• Ureteral duplication
• Children