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Pediatric surgery

Find all the surgical interventions, lectures, experts opinions, debates, webinars and operative techniques per specialty.
Laparoscopic partial nephrectomy on non-functional, symptomatic right lower pole of the kidney
In this video, we present the case of a 13-year-old girl presenting with a complicated urological anomaly discovered very late. The lower part of her right kidney is dysplastic (or destroyed) with pseudocystic pyelocalyceal cavities filled with stones and cloudy urine. The first hypothesis is that we are dealing with a true renal duplicity with a destroyed non-functional inferior pole. In this case, there is one ureter per kidney pole. As a result, polar ureteronephrectomy does not cause any potential vascular problems.
In this case, thanks to 3D reconstruction (Visible Patient™, a spinoff of IRCAD), it is clear that there is no kidney duplicity, but a pyelic bifurcation. It means that we should manage the only ureter, which drains the superior and inferior pelvis. For that reason, the placement of a double J catheter is essential prior to partial nephrectomy. This catheter should be pulled up until the superior pelvis.
Tridimensional reconstruction of the CT-scan images of a patient with a malformation is extremely helpful to better understand the original and unique anatomy of the patient and to determine a tailored operative strategy.
This video demonstrates a laparoscopic partial nephrectomy on non-functional, symptomatic right lower pole of the kidney in a 13-year-old girl as an outpatient surgery.
F Becmeur, A Lachkar, L Soler
Surgical intervention
9 months ago
1760 views
2 likes
0 comments
07:24
Laparoscopic partial nephrectomy on non-functional, symptomatic right lower pole of the kidney
In this video, we present the case of a 13-year-old girl presenting with a complicated urological anomaly discovered very late. The lower part of her right kidney is dysplastic (or destroyed) with pseudocystic pyelocalyceal cavities filled with stones and cloudy urine. The first hypothesis is that we are dealing with a true renal duplicity with a destroyed non-functional inferior pole. In this case, there is one ureter per kidney pole. As a result, polar ureteronephrectomy does not cause any potential vascular problems.
In this case, thanks to 3D reconstruction (Visible Patient™, a spinoff of IRCAD), it is clear that there is no kidney duplicity, but a pyelic bifurcation. It means that we should manage the only ureter, which drains the superior and inferior pelvis. For that reason, the placement of a double J catheter is essential prior to partial nephrectomy. This catheter should be pulled up until the superior pelvis.
Tridimensional reconstruction of the CT-scan images of a patient with a malformation is extremely helpful to better understand the original and unique anatomy of the patient and to determine a tailored operative strategy.
This video demonstrates a laparoscopic partial nephrectomy on non-functional, symptomatic right lower pole of the kidney in a 13-year-old girl as an outpatient surgery.
Total nephrectomy in children by a lateral retroperitoneoscopic approach
This didactic video demonstrates the retroperitoneal approach to nephrectomy in children. A simple technique for creation of the retroperitoneal space and different methods of dissection, vessel division and specimen extraction are presented. These techniques are applicable for use in patients ranging from infants to adolescents.

The tip of the telescope progressively enlarges the working space created in the retroperitoneoscopic approach. This frees retroperitoneal fibrous tissues behind the kidney. The authors place two additional ports under direct vision: one to gently sweep the peritoneum anteriorly and to increase the working space for the placement of a third trocar.
JS Valla
Surgical intervention
12 years ago
217 views
32 likes
0 comments
08:53
Total nephrectomy in children by a lateral retroperitoneoscopic approach
This didactic video demonstrates the retroperitoneal approach to nephrectomy in children. A simple technique for creation of the retroperitoneal space and different methods of dissection, vessel division and specimen extraction are presented. These techniques are applicable for use in patients ranging from infants to adolescents.

The tip of the telescope progressively enlarges the working space created in the retroperitoneoscopic approach. This frees retroperitoneal fibrous tissues behind the kidney. The authors place two additional ports under direct vision: one to gently sweep the peritoneum anteriorly and to increase the working space for the placement of a third trocar.