Laparoscopic nephrectomy for hydronephrosis management in a General Hospital. Case report and literature review

José Ignacio Díaz-Pizarro Graf; Mucio Moreno Portillo; Carlos Pacheco Gahbler; Sergio Basurto Ballesteros; Erick Stanley Petersen Juárez; Mauro Eduardo Ramírez Solís

2001, Number 4

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Rev Mex Cir Endoscop 2001; 2 (4)

Laparoscopic nephrectomy for hydronephrosis management in a General Hospital. Case report and literature review

Díaz-Pizarro GJI, Moreno PM, Pacheco GC, Basurto BS, Stanley PJE, Ramírez SME

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Language: Spanish
References: 23
Page: 200-205
PDF size: 137.24 Kb.

ABSTRACT

Background: It is necessary to morcelate or extend an incision to extract the kidney during laparoscopic nephrectomy. This operation is rarely done outside specialized Laparoscopic Urology Centers, because only these comprise the required technology. Methods (Case): 38 year-old female with history of left oophorectomy, c-section and bilateral tubal ligation, referring asymptomatic abdominal mass during pregnancy, ultrasound shows left hydronephrosis. Percutaneous nephrostomy is done until delivery is carried-out. Then an intravenous pyelogram demonstrates left renal exclusion and normal right kidney. Renal gammagram confirms left renal exclusion and computed tomography corroborates left hydronephrosis. Four-port trans-abdominal laparoscopic left nephrectomy was done using cautery and sutures, without ultrasonic scalpel; the empty hydronephrotic sac was extracted trough one of the ports without extending the incision and closed a drainage was placed. The patient was discharged two days after and followed at the office without complications. Conclusions: Hydronephrosis can be treated by a totally laparoscopic approach, since the empty hydronephrotic sac can be extracted trough one of the ports. Also, it is possible to perform it with the simple equipment that any hospital with experience in laparoscopic surgery has, without the technological implements that only specialized centers do have.

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