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Laparoscopic renal surgery in infants 10 kg or less.

BACKGROUND AND PURPOSE
Major laparoscopic urologic procedures have been successful in children, but few reports of laparoscopic surgery in infants weighing <10 kg exist. We present our series of laparoscopic renal procedures in such patients.


PATIENTS AND METHODS
The hospital records of 17 consecutive patients (9 boys, 8 girls) with a median age of 7 months (range 1-25 months) weighing a mean of 8.5 kg (range 4.2-10 kg) who had undergone laparoscopic renal surgery (nephrectomy, partial nephrectomy, nephroureterectomy) between March 1999 and January 2004 were reviewed. Twelve patients underwent laparoscopic nephrectomy, three laparoscopic nephroureterectomy, and two laparoscopic heminephrectomy. Additional procedures were performed concomitantly in three patients.


RESULTS
All operations had minimal estimated blood loss. Excluding those patients who underwent additional procedures, the mean operative time was 138 minutes (range 77-229 minutes). The postoperative hospitalization was 23 hours or less in all except two patients, both of whom had undergone additional procedures. The only complication was an intraoperative diaphragmatic injury that was repaired laparoscopically without sequelae. There were no delayed complications, and by 2 weeks postoperatively, all patients were recovered fully.


CONCLUSION
Major laparoscopic urologic procedures can be performed in infants weighing <10 kg with low morbidity and rapid recovery.