Modified minimal cost retroperitoneoscopic nephrectomy, nephrectomy with isthumusectomy and nephroureterectomy in children: a pilot study

Objective To assess the feasibility of retroperitoneoscopic nephrectomy, ne phrectomy with isthmusectomy and nephroureterectomy in children with nonfun ctioning kidneys and renal anomalies, at minimal cost using a modified tech nique. Patients and methods Eleven children (aged 4-16 years) underwent retroperit oneoscopic nephrectomy, nephroureterectomy, or nephrectomy with isthmusecto my for nonfunctioning kidneys, Three patients had previously undergone perc utaneous nephrostomy to evaluate whether the kidney could be salvaged, but this did not alter the success of technique, although adhesions and fibrosi s required careful and precise dissection. Results All procedures were completed successfully with minor complications (peritoneal transgression via the port in two patients, with no consequenc es). The mean operative duration, blood loss and hospital stay were 109 min , 82 mL and 2.25 days, respectively. Conclusion Retroperitoneoscopic procedures can be conducted safely, success fully and at minimal cost without compromising any principles of technique. It is not essential to prepare the bowel or use ureteric catheterization a nd renal artery embolization. Expensive balloon dissectors, trocar-sealing balloons, endostaplers and endobags, lap sacs or morcellators are not requi red. The direct approach to the kidney via retroperitoneoscopy is also quic ker.