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VR-4
(VS)
LAPAROSCOPIC SINGLE SITE NEPHRECTOMY IN INFANT WITH SYMPTOMATIC
MULTICYSTIC DYSPLASTIC KIDNEY.
Young Jae IM, Sang Woon KIM, Yong Seung LEE, Byung Hoon CHI and Sang Won HAN
Severance Children's Hospital, Yonsei University Health System, Pediatric Urology, Seoul, KOREA (REPUBLIC OF)
PURPOSE
Multicystic dysplastic kidney (MCDK) is the most common renal cystic disease in children. Nephrectomy is reserve for
some special indications such as recurrent urinary tract infection (UTI) and abdominal pain, etc. We present the
experience of laparoendoscopic single site (LESS) nephrectomy in 2 month old infant with huge MCDK.
MATERIAL AND METHODS
A 2 month old girl with right MCDK detected by prenatal ultrasound was admitted due to recurrent UTI and abdominal
distension. MRI showed multiple cysts on right kidney, the largest diameter was 7.5cm. Right ureter entered into right
vagina. After a 1.5cm umbilical incision was made, we made homemade transumbilical port with Alexis wound retractor
and surgical glove. First, we aspirated urine of largest cyst to reduce the size of right MCDK and dissected from the
surrounding tissue with thermal ligation. The port was removed and then the MCDK was retrieved through the umbilical
incision.
RESULTS
Total operative time was 93 min, blood loss was less than 10cc. There were no preioperative complications. The patient
was diacharged on 3-days postoperatively. The bulging in vaginal introitus was resolved immediately after operation.
There was no recurrence of UTI during one year follow-up
CONCLUSIONS
Symptomatic MCDK should be considered to remove. LESS for huge MCDK is a safe and feasible operation with better
cosmesis, compared with open or classic laparoscopic nephrectomy. LESS is a promising technique in infant with
urogenital anomalies.