Laparoscopic Heminephroureterectomy in Infants Weighing Less Than 10 Kilograms: The Two Peculiar Cases

Abstract

Ab s t r Ac t Aim: We report two peculiar cases of laparoscopic heminephrectomy in infants weighing less than 10 kg with megaureter of nonfunctioning renal upper pole. Cases description: A 6-month-old boy, with history of upper pole pyo-hydroureteronephrosis managed by percutaneous nephrostomy, was affected in the left side; while a 17-month-old girl, with history of abdominal mass then proved to be a giant megaureter of nonfunctioning renal upper pole, was affected in the right side and she was previously treated for primitive obstructive megaureter (in the lower pole). Laparoscopic heminephroureterectomy with a transperitoneal approach was performed. Mean length of surgery was 160 minutes. We reported no conversion to open surgery neither intraoperative bleeding/urine leakage. Mean hospitalization duration was 5 days. The reoperation rate was 0%. In both cases at preliminary follow-up, we reported a good outcome. Conclusion: Laparoscopic heminephrectomy is considered a technically challenging procedure, especially for small infant but, according to our experience, it is safe and effective if performed in pediatric centers with high experience in minimally invasive surgery.