Laparoscopic heminephrectomy for upper-pole moiety in children using a 3-mm laparoscope and instruments

We report three cases of laparoscopic heminephrectomy in infants using a 3-mm laparoscope and instruments. To our knowledge, this is the first pediatric heminephrectomy series reported in the literature that utilized these small instruments.

Three pediatric patients underwent laparoscopic heminephrectomy for an upper-pole moiety in a duplicated collecting system with 3-mm laparoscopic ports and a 3-mm Storz 30 degrees laparoscope.

All three cases were completed laparoscopically with total times of 120, 135, and 160 minutes. There were no intraoperative complications, and there was minimal blood loss. The optics of the laparoscope provided visibility and illumination similar to those available with larger-diameter laparoscopes. Two patients were discharged approximately 1 day postoperatively. The third patient required intravenous antibiotics to treat a urinary-tract infection and was discharged home 4 days postoperatively. All three patients had recovered fully by 2 weeks.

The 3-mm laparoscope provides excellent visibility and illumination for performing heminephrectomy in the pediatric population. In addition, the 3-mm instruments provide excellent tissue handling, similar to that of the 5-mm tools.