Complications of Pediatric Urological Laparoscopy: Mistakes and Risks

Esposito, Ciro; Lima, Mario; Mattioli, Girolamo; Mastroianni, L.; Centonze, Antonella; Monguzzi, G; Montinaro, L.; Riccipetitoni, Giovanna; Garzi, Alfredo; Savanelli, Antonio; Damiano, Rocco; Messina, Mario; Settimi, Alessandro; Amici, G.; Jasonni, Vincenzo

doi:10.1097/01.ju.0000055256.43528.f6

Cited by 53 publications

(23 citation statements)

References 15 publications

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“…A multicentre paediatric laparoscopic study including various procedures (of 701 cases 34 were nephrectomy) reported a complication rate of 2.7% total [12]. The conversion rate is variable from 11 to 5% [13].…”

Section: Discussionmentioning

confidence: 98%

An initial experience of 100 paediatric laparoscopic nephrectomies with transperitoneal or posterior prone retroperitoneoscopic approach

et al. 2007

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The objective of this study was to evaluate the outcome of the initial 100 consecutive laparoscopic nephrectomies using a transperitoneal or a posterior prone retroperitoneoscopic approach. The medical records of 97 consecutive children who underwent laparoscopic nephrectomy between January 2000 and December 2003 were reviewed. Children having concomitant operative procedures were excluded from the study. Laparoscopy was performed by a transperitoneal (TP) or a posterior prone retroperitoneoscopic (PPR) approach based on the preference of the operating surgeon. A total of 100 procedures were successfully completed laparoscopically. Two children required conversion to open surgery. The median operating time was 112 min for the TP approach and 96 min for the PPR approach (P = 0.002). There was no significant difference in the analgesic requirements between the two groups. The rate of complications was similar, as was the length of hospital stay. This was despite the fact that the children in the TP group were somewhat older in age. In children having bilateral native kidney nephrectomy, peritoneal dialysis was successfully established within 48 h after surgery in the PPR group. Taking into account the heterogeneous nature of our group of patients, a reliable conclusion in regard to the difference in operative time, analgesic requirement or approach could not be ascertained. There is the suggestion however, that both the TP and PPR approaches for nephrectomy are equally applicable in children. The posterior prone retroperitoneoscopic approach may have an advantage in children who require peritoneal dialysis.

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Section: Discussionmentioning

confidence: 98%

An initial experience of 100 paediatric laparoscopic nephrectomies with transperitoneal or posterior prone retroperitoneoscopic approach

et al. 2007

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“…Thus, the assurance of safety is paramount and particularly relevant when dealing with children. In terms of the incidence of complications, Esposito et al [10] examined the incidence of laparoscopic complications in children at 8 Italian centers of pediatric surgery and urology and found no significant differences between experienced and less experienced laparoscopic teams. In the present series, no major perioperative complications occurred and estimated blood loss was minimal.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic nephrectomy for renal diseases in children: is there a learning curve?

Yeo

Kim

et al. 2005

Journal of Pediatric Surgery

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“…Other operative complications are quite uncommon and include the following: injury to the abdominal viscera (in case of blind insertion of the first trocar when performed after Veress needle insufflations), injury to the bladder (especially during the Prentiss maneuver if the catheter drainage has not been verified), bleeding due to damage of great vessels (which could even require emergent conversion to open laparotomy), mechanical injury to the vas deferens during mobilization, and indirect inguinal hernia (Esposito et al 2003;Metwalli and Cheng 2002).…”

Section: Complicationsmentioning

confidence: 99%