Transperitoneal Laparoscopic Approach to the Perinephric Area in Children: Technical Report and Lessons Learned

Purpose: This study presents a technical report of a standardized approach to the perinephric area in a series of pediatric patients, demonstrating that whatever renal or suprarenal surgery is planned, this can be approached and accomplished laparoscopically with an identical or very similar port triangulation, thus facilitating the learning curve within the same surgical team. Patients and Methods: All patients undergoing renal and adrenal gland surgery with a minimally invasive approach in the period from October 2008 to November 2013 were retrospectively reviewed and included in the study. Technical details and clinical outcomes are described. Results: In total, 68 patients matched the inclusion criteria and were therefore retrospectively examined. No major intraoperative complication occurred. Two patients developed recurrent pelvic-ureteric junction obstruction and were managed with double J stent positioning and laparoscopic dismembered pyeloplasty, respectively. Two patients presenting with adrenal mass experienced a moderate bleeding that could be treated conservatively. Conclusions: Thanks to the reproducibility of the procedure and on the grounds of the presented experience, we support the proposal that the transperitoneal laparoscopic approach to the kidney and the adrenal gland could represent a relatively easy and safe way to quickly achieve confidence and skill in the management of related diseases.