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Single Incision Miniature Pyeloplasty and Ipsilateral Inguinal Herniorrhaphy in Infants

2010; Lippincott Williams & Wilkins; Volume: 183; Issue: 4 Linguagem: Inglês

10.1016/j.juro.2009.12.050

1527-3792

Abdol‐Mohammad Kajbafzadeh, Ali Tourchi, Soroush Bazargani, Behtash Ghazi Nezami,

Hernia repair and management

No AccessJournal of UrologyPediatric Urology1 Apr 2010Single Incision Miniature Pyeloplasty and Ipsilateral Inguinal Herniorrhaphy in Infants Abdol-Mohammad Kajbafzadeh, Ali Tourchi, Soroush Bazargani, and Behtash Ghazi Nezami Abdol-Mohammad KajbafzadehAbdol-Mohammad Kajbafzadeh , Ali TourchiAli Tourchi , Soroush BazarganiSoroush Bazargani , and Behtash Ghazi NezamiBehtash Ghazi Nezami View All Author Informationhttps://doi.org/10.1016/j.juro.2009.12.050AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We describe a single incision miniature open pyeloplasty and retroperitoneal herniorrhaphy technique in infants. Materials and Methods: A total of 22 patients with ureteropelvic junction obstruction and concomitant inguinal hernia were referred to our center between November 2003 and November 2008. A total of 13 patients (mean age 5 months) with extensively dilated pelves (extending down to pelvic cavity) and ipsilateral inguinal hernia underwent single incision miniature open pyeloplasty and retroperitoneal herniorrhaphy. All patients had decreased differential renal function (less than 40%), urinary tract infection, palpable kidney and obstructive pattern on renal diethylenetriamine pentaacetic acid scan. The incision was made along the most dependent part of the lower quadrant. After dissection of the ureteropelvic junction component, we pulled out the affected section and performed classic dismembered pyeloplasty without renal pelvis reduction. Next, we performed retroperitoneal herniorrhaphy from the same incision. Surgical incision size, operative time, hospital stay, postoperative analgesic use and complication rate were recorded for further evaluation. Results: The operation was uneventful in all patients. Mean operative time was 64 minutes (range 47 to 93) and patients were discharged home after a mean ± SD of 19 ± 3 hours (15 to 24). Incision size was 12 to 18 mm and the incision was closed by inserting a mini Hemovac® closed drain. No narcotic supplementation was required postoperatively and there were no complications during followup. Conclusions: Single incision miniature pyeloplasty with ipsilateral inguinal herniorrhaphy in an extensively dilated pelvis and ipsilateral inguinal hernia is technically feasible and safe in selected cases. The exact incision site must be reconfirmed intraoperatively by physical examination or renal ultrasound. The technique adds the advantages of minimally invasive procedures (small incision, negligible postoperative pain) to the short operative time and high success rate of the open approach. References 1 : Laparoscopic pyeloplasty for repair of pelvi-ureteric junction obstruction in children. J Pediatr Urol2009; 5: 25. 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Br J Surg2007; 94: 804. Google Scholar 17 : A long-term prospective analysis of pediatric unilateral inguinal hernias: should laparoscopy or anything else influence the management of the contralateral side?. J Pediatr Urol2008; 4: 141. Google Scholar Department of Urology, Pediatric Urology Research Center, Pediatric Center of Excellence, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byGargollo P (2011) Hidden Incision Endoscopic Surgery: Description of Technique, Parental Satisfaction and ApplicationsJournal of Urology, VOL. 185, NO. 4, (1425-1431), Online publication date: 1-Apr-2011. Volume 183Issue 4April 2010Page: 1545-1550 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.Keywordsminimally invasiveherniasurgical procedureskidney pelvisureteral obstructioninguinalMetricsAuthor Information Abdol-Mohammad Kajbafzadeh More articles by this author Ali Tourchi More articles by this author Soroush Bazargani More articles by this author Behtash Ghazi Nezami More articles by this author Expand All Advertisement PDF downloadLoading ...