Laparoscopic nephropexy
This procedure entails affixing the kidney to the stomach wall. In the past, with only the traditional, open surgery methods available, nephropexy was very rarely performed. Nowadays, with the advance of laparoscopy, we are seeing an increasing number of this procedure, mainly done transperitoneally.
When is it needed?
Laparoscopic nephropexy is used to treat mobile kidneys and the downward displacement of the kidney, known as nephroptosis. This condition causes an obstruction in effectively draining urine from the kidney. The most common candidates for these procedures are younger, usually underweight women, and the problem most commonly occurs on the right kidney.
How is it performed?
In order to perform laparoscopic nephropexy, we require 3 trocars inserted usually through right side of the abdomen. After detaching the upper and middle sections of the kidney from the surrounding tissue, a special stitching is used to suture and fixate the lower part of the kidney to the posterior muscle wall. 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 laparoscopic nephropexies are very rare. The most common possible complication is bleeding that rarely requires a blood transfusion. There are also 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. Approximately less than 1% of laparoscopic nephropexy surgeries require a conversion to the open surgical approach.
