Laparoscopic nephrectomy
This procedure entails the surgical removal of the kidneys via the laparoscopic technique. Depending on the kidney size, previous surgeries, and other factors, the two most common approaches are transperitoneal and extraperitoneal.
When is it needed?
This procedure is normally favored in patients with a non-functional kidney.
How is it performed?
In order to perform laparoscopic nephrectomy, we require 3-4 trocars inserted through the left or right side of the abdomen. The main part of the surgery involves detaching the kidney from the surrounding tissue, and disconnecting the ureters and blood vessels. The removed kidney is placed in an endoscopic bag which is extracted through one of the trocar incisions, which is expanded as much or as little as the kidney size requires. Then, a thin drainage tube is inserted in order to monitor possible post-operative bleeding, the remaining trocars are removed, and the incisions are stitched up.
What are the possible complications?
Complications in these surgeries are very rare. The most common possible complication is bleeding that might require a blood transfusion. The transperitoneal approach involves general risks of laparoscopic surgery, such as the damage of stomach organs, the diaphragm, or blood vessels. These risks are minimal and occur in less than 1% of all patients. It’s worth noting that approximately 5% of laparoscopic nephrectomies require a conversion to the open surgical approach, but in the hands of experienced laparoscopists, these chances are decreased to 1%.
Laparoscopic nephrectomy in polycystic kidney degeneration
Despite the fact that kidneys have a chance to grow beyond 40 cm in length in patients with PKD, laparoscopic nephrectomy is still a legitimate choice of treatment. With some adjustments to the transperitoneal laparoscopic technique, these kidneys are feasibly removable with significantly fewer post-operative side-effects and scarring than if done openly. This also makes it considerably easier to perform a potential kidney transplant, if and when necessary.
