Complications of pediatric urological laparoscopy: mistakes and risks

Purpose: We evaluate the results and complications of laparoscopic urological procedures in children. Materials and Methods: In a 3-year period 4,350 laparoscopic procedures were performed at 8 Italian centers ofpediatric surgery. We analyzed only the data ofurological procedures for a total of 701 laparoscopic operations on patients 1 month to 14 years old. The indications for surgery were cryptorchidism in 414 cases, varicoceles in 159, ambiguous genitali a in 37, total nephrectomy in 34, partial nephrectomy in 4, adrenalectomy in 3 and other diagnostic procedures in 50. We adopted a retroperitoneoscopic approach in 72 cases (10.3%) and a laparoscopic approach in 629 (89.7%). Patient records were analyzed to search for any complication that may have occurred during the laparoscopic procedure and assess how they were managed. Results: We recorded 19 complications (2.7%) in our series, of which 6 required conversion to open surgery. and 13 did noto There was no mortality. At a maxirnum followup of 4 years all children were alive and had no problems related to the laparoscopic complications. Conclusions: Our study shows that pediatric laparoscopic urological surgery has an acceptable rate of complications with no mortality. We believe that routine use of open laparoscopy in pediatric patients is a key factor to help avoid complications. Most complications can be avoided with surgeon and team experience, together with proper compliance with the indications for surgery.