Our Summary

This research paper looks at a type of surgery called Laparoendoscopic single-site surgery (LESS) that was performed on 31 children with different urologic diseases. In this surgery, a small cut of 15 to 20 mm is made in the belly button area and instruments are inserted to perform the surgery. The surgeries included were for conditions like blockage in the urinary tract, kidney removal, treatment for enlarged veins in the scrotum, testicle removal, repositioning of an undescended testicle, and removal of female genitalia.

The researchers looked back at the medical records of these patients to see how well the surgeries went and what the outcomes were. For the 21 patients who had surgery for urinary tract blockage, the average surgery time was 240 minutes and all of them had relief from kidney swelling. For the 4 patients who had their kidney removed, the average surgery time was 128 minutes and all of them stopped having urinary incontinence. The average time for the surgery to treat enlarged veins in the scrotum was 73 minutes and all patients had disappearance of the condition without any testicle shrinkage. The times for the surgeries to remove a testicle, reposition an undescended testicle, and remove female genitalia were 60, 170, and 189 minutes respectively. There were no complications during or after the surgeries in all cases.

The paper concludes that LESS has several benefits including a smaller scar and less pain, making it a less stressful surgery option for children.

FAQs

  1. What is Laparoendoscopic single-site surgery (LESS) and what pediatric urologic diseases can it be used for?
  2. What are the advantages of Laparoendoscopic single-site surgery (LESS) in pediatric patients?
  3. Can you explain the postoperative outcomes of these LESS procedures as mentioned in the article?

Doctor’s Tip

A helpful tip a doctor might tell a patient about pediatric urologic reconstruction is to follow postoperative care instructions closely to ensure proper healing and minimize the risk of complications. This may include taking prescribed medications, keeping the surgical site clean and dry, and attending follow-up appointments as scheduled. It is also important to communicate any concerns or unusual symptoms to the healthcare provider promptly.

Suitable For

Pediatric patients who are recommended for pediatric urologic reconstruction procedures such as pyeloplasty, nephrectomy, varicocele ligation, orchiectomy, orchiopexy, and removal of female genitalia mutilation are typically those with conditions such as ureteropelvic junction obstruction, renal tumors, varicoceles, undescended testes, or female genitalia mutilation. These patients may experience symptoms such as renal pelvis dilatation, urinary incontinence, varicocele, testicular atrophy, or genitalia scarring. In these cases, laparoendoscopic single-site surgery (LESS) may be recommended as a less invasive and aesthetically superior surgical option for pediatric patients.

Timeline

Before pediatric urologic reconstruction:

  • Patient is diagnosed with a urologic condition such as pyeloplasty, nephrectomy, varicocele, orchiectomy, orchiopexy, or removal of female genitalia
  • Consultation with pediatric urologist and discussion of treatment options
  • Preoperative testing and preparation for surgery

After pediatric urologic reconstruction:

  • Surgery is performed using laparoendoscopic single-site surgery (LESS) technique
  • Intraoperative outcomes are monitored, such as operation time and complications
  • Postoperative outcomes are evaluated, such as relief of symptoms, disappearance of urologic conditions, and improvement in urinary function
  • Follow-up appointments with pediatric urologist to monitor recovery and ensure proper healing
  • Long-term follow-up to assess the success of the reconstruction and overall health of the patient

What to Ask Your Doctor

  1. What specific procedure do you recommend for my child’s urologic condition?
  2. What are the potential risks and complications associated with pediatric urologic reconstruction surgery?
  3. How experienced are you in performing pediatric urologic reconstruction surgeries, particularly with the specific procedure you are recommending?
  4. What is the expected recovery time for my child after undergoing pediatric urologic reconstruction surgery?
  5. Will my child need any follow-up procedures or treatments after the surgery?
  6. Are there any alternative treatment options to consider besides surgery?
  7. How will the surgery impact my child’s long-term urologic health and quality of life?
  8. Will my child require any special care or accommodations during the recovery period?
  9. Are there any specific dietary or activity restrictions my child should follow before or after the surgery?
  10. What steps can be taken to minimize scarring and discomfort for my child after the surgery?

Reference

Authors: Yamada Y, Naitoh Y, Kobayashi K, Fujihara A, Johnin K, Hongo F, Naya Y, Kamoi K, Okihara K, Kawauchi A, Miki T. Journal: J Endourol. 2016 Jan;30(1):24-7. doi: 10.1089/end.2015.0130. Epub 2015 Oct 27. PMID: 26411287