Background: Laparoscopic renal surgery has become an accepted approach for benign disease in
adult and pediatric urology. We present our experience in renal laparoscopy in infants during the
past 5 years and evaluate our series to establish the safety and efficacy of such procedures in children.
Materials and Methods: From August 1999 to December 2004, we performed 32 renal laparoscopic
procedures on 31 children aged 12 months to 16 years (mean, 42 months). Twenty-seven patients
underwent unilateral retroperitoneal nephrectomy; 1 child with Denis Drash syndrome underwent
transperitoneal bilateral nephrectomy; 2 children underwent renal cyst unroofing; and 1 child with
lymphoma underwent retroperitoneal laparoscopic renal biopsy. Indications for surgery were: renal
function >9% in cases of unilateral nephrectomy; the prevention of renal neoplastic changes in
the patient with Denys-Drash syndrome; symptomatic large renal cysts; and suspected lymphoma
not diagnosed with a previous percutaneous biopsy.
Results: All procedures were completed laparoscopically. In 6 cases, the accidental opening of the peritoneum
did not require conversion to open surgery. Intraoperative blood loss was minimal. One patient
who underwent a retroperitoneal nephrectomy required a blood transfusion for postoperative bleeding
into the retroperitoneal space. Twenty-four of 27 unilateral retroperitoneal nephrectomy patients were
discharged on postoperative day 2. Mean follow-up was 30 months (range, 6–64 months). Cosmetic results
were excellent in all patients and no long-term complications have been encountered so far.
Conclusion: Laparoscopic urologic surgery may be performed in children with minimal morbidity,
minimal postoperative discomfort, improved cosmetic results, and a short hospital stay.
