Laparoscopic Nephrectomy Via the Reproperitoneal Approach

Abstract
We evaluated efficacy of the retroperitoneal approach for laparoscopic nephrectomy of kidneys with benign disease. Eight men and 12 women (mean age 55 years) with severely damaged kidneys underwent laparoscopic retroperitoneal nephrectomy. One patient had a history of multiple open abdominal and gynecological operations. Kidneys were removed laparoscopically from the working space, which was created by finger and balloon dissection, and maintained by carbon dioxide insufflation in the retroperitoneal cavity. All kidneys were removed successfully via this procedure. Mean operative time was 3.3 hours and mean estimated blood loss was 135 ml. One patient experienced bleeding from the injured capsular artery just after removal of the kidney. The retroperitoneal approach is recommended for laparoscopic nephrectomy.