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The evolving role of laparoscopic surgery in paediatric urology.

Hidas G, Watts B, Khoury AE - Arab J Urol (2012)

Bottom Line: We searched PubMed for human studies in English that were published between 1990 and the present, focusing on laparoscopic nephrectomies and partial nephrectomies, laparoscopic and robotic pyeloplasties and ureteric reimplantation, laparoscopic orchidopexy and varicocelectomy.Key articles were reviewed, extracting the indications, techniques, and the advantages and disadvantages.Robotic-assisted laparoscopic surgery is developing as a safe and effective option even for infant patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Paediatric Urology, UC Irvine and Children's Hospital of Orange County, Orange, CA, USA.

ABSTRACT

Objectives: We review the various applications of laparoscopic and robotic-assisted laparoscopy in paediatric urology, as the laparoscopic and robotic approach in this population is gradually being recognised.

Methods: We searched PubMed for human studies in English that were published between 1990 and the present, focusing on laparoscopic nephrectomies and partial nephrectomies, laparoscopic and robotic pyeloplasties and ureteric reimplantation, laparoscopic orchidopexy and varicocelectomy. We also reviewed robotic-assisted laparoscopic urological major reconstructions. Key articles were reviewed, extracting the indications, techniques, and the advantages and disadvantages.

Results and conclusions: Laparoscopy has a defined place in modern paediatric urological surgery. Laparoscopic nephrectomies, pyeloplasties and abdominal exploration for the evaluation and management of impalpable undescended testicles have become the standard of care. Robotic-assisted laparoscopic surgery is developing as a safe and effective option even for infant patients.

No MeSH data available.


Related in: MedlinePlus

(a) A distended left spermatic vein before clipping and (b) a collapsed spermatic vein after clipping.
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f0015: (a) A distended left spermatic vein before clipping and (b) a collapsed spermatic vein after clipping.

Mentions: A varicocele is present in 10–15% of the adolescent male population [43]. The major indications for varicocele treatment include failure of testicular growth, testicular pain, diminished fertility and cosmesis. Loss of testicular volume is defined as >20% of testicular size between the testicles, as measured by ultrasonography. After successful varicocele surgery compensatory testicular growth occurs in 50–80% of patients [44]. Several studies confirmed the efficacy of the laparoscopic approach to ligation of the spermatic vein (Fig. 3). Podkamerer et al. [45] evaluated 654 patients randomly assigned to LV or open varicocele repair. In all cases, the modified Palomo technique with lymphatic preservation was used. Success rates were measured by the rate of recurrence and occurrence of hydrocele; these were similar in the two groups. The LV group had a shorter operative time and recovery; postoperative analgesic use was almost half after LV. Barroso et al. [46] reported a systematic review comparing 1344 LV and 496 open spermatic vein ligations. The rate of hydrocele formation was not statistically different between the groups, both in the Palomo (mass ligation of the spermatic vessels) and modified Palomo (spermatic artery preservation) procedures.


The evolving role of laparoscopic surgery in paediatric urology.

Hidas G, Watts B, Khoury AE - Arab J Urol (2012)

(a) A distended left spermatic vein before clipping and (b) a collapsed spermatic vein after clipping.
© Copyright Policy - CC BY-NC-ND
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4442882&req=5

f0015: (a) A distended left spermatic vein before clipping and (b) a collapsed spermatic vein after clipping.
Mentions: A varicocele is present in 10–15% of the adolescent male population [43]. The major indications for varicocele treatment include failure of testicular growth, testicular pain, diminished fertility and cosmesis. Loss of testicular volume is defined as >20% of testicular size between the testicles, as measured by ultrasonography. After successful varicocele surgery compensatory testicular growth occurs in 50–80% of patients [44]. Several studies confirmed the efficacy of the laparoscopic approach to ligation of the spermatic vein (Fig. 3). Podkamerer et al. [45] evaluated 654 patients randomly assigned to LV or open varicocele repair. In all cases, the modified Palomo technique with lymphatic preservation was used. Success rates were measured by the rate of recurrence and occurrence of hydrocele; these were similar in the two groups. The LV group had a shorter operative time and recovery; postoperative analgesic use was almost half after LV. Barroso et al. [46] reported a systematic review comparing 1344 LV and 496 open spermatic vein ligations. The rate of hydrocele formation was not statistically different between the groups, both in the Palomo (mass ligation of the spermatic vessels) and modified Palomo (spermatic artery preservation) procedures.

Bottom Line: We searched PubMed for human studies in English that were published between 1990 and the present, focusing on laparoscopic nephrectomies and partial nephrectomies, laparoscopic and robotic pyeloplasties and ureteric reimplantation, laparoscopic orchidopexy and varicocelectomy.Key articles were reviewed, extracting the indications, techniques, and the advantages and disadvantages.Robotic-assisted laparoscopic surgery is developing as a safe and effective option even for infant patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Paediatric Urology, UC Irvine and Children's Hospital of Orange County, Orange, CA, USA.

ABSTRACT

Objectives: We review the various applications of laparoscopic and robotic-assisted laparoscopy in paediatric urology, as the laparoscopic and robotic approach in this population is gradually being recognised.

Methods: We searched PubMed for human studies in English that were published between 1990 and the present, focusing on laparoscopic nephrectomies and partial nephrectomies, laparoscopic and robotic pyeloplasties and ureteric reimplantation, laparoscopic orchidopexy and varicocelectomy. We also reviewed robotic-assisted laparoscopic urological major reconstructions. Key articles were reviewed, extracting the indications, techniques, and the advantages and disadvantages.

Results and conclusions: Laparoscopy has a defined place in modern paediatric urological surgery. Laparoscopic nephrectomies, pyeloplasties and abdominal exploration for the evaluation and management of impalpable undescended testicles have become the standard of care. Robotic-assisted laparoscopic surgery is developing as a safe and effective option even for infant patients.

No MeSH data available.


Related in: MedlinePlus