Laparoscopic renal cyst fenestration
Laparoscopic fenestration or marsupialization involve cutting into one or more simple or complex renal cysts. Taking the anatomical position of the cyst into consideration, we either take the transperitoneal or extraperitoneal route.
When is it needed?
It’s necessary in paces with large renal cysts, both simple and complex, with thicker walls or septums. Especially in the case of complex cysts, the point of the operation isn’t just to remove them, but also to do a histopathological analysis of the cyst’s wall and/or septum.
How is it performed?
In order to perform laparoscopic renal cyst fenestration, we require 3 trocars inserted through the left or right side of the abdomen. After detaching the kidney from the surrounding tissue in the location of the cyst, we excise the cyst wall and septums, depending on the complexity of the cyst. The removed tissue is placed into an endoscopic bag, which is extracted through one of the trocar incisions. A drainage tube is then inserted 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 renal cyst fenestration 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 1% of laparoscopic fenestration procedures require a conversion to the open surgical approach.
