[Transumbilical laparoscopic simple nephrectomy using a flexible cystoscope and standard laparoscopic instruments]

Area of Science:

• Urologic Surgery
• Minimally Invasive Procedures
• Pediatric Surgery

Background:

• Recurrent urinary tract infections (UTI) and pyelonephritis can lead to severe renal parenchymal atrophy.
• Simple nephrectomy is a treatment option for end-stage renal disease secondary to chronic infection.
• Single-port laparoscopic surgery offers potential benefits in terms of cosmesis and reduced invasiveness.

Observation:

• A 15-year-old patient with left renal atrophy underwent a transumbilical single-port laparoscopic simple nephrectomy.
• The procedure utilized a flexible cystoscope and standard laparoscopic instruments, including a PKS Plasma Trissector and Weck clips.
• A Maryland grasper was introduced without a port for countertraction, demonstrating adaptability of surgical techniques.

Findings:

• The transumbilical single-port nephrectomy was performed successfully without complications.
• The mean operative time was 90 minutes, with an average blood loss of 200 mL.
• The patient experienced an 18-hour hospital stay with no need for blood transfusion.

Implications:

• Transumbilical single-port surgery shows promise for expanding minimally invasive urologic procedures in pediatric patients.
• The versatility of existing urologic instruments allows for their adaptation in novel surgical settings.
• Further development and commercial availability of specialized hardware could enhance the broader adoption of single-port urologic surgery.