title: Transperitoneal and retroperitoneal laparoscopic nephrectomy for giant hydronephrosis.
abstract: OBJECTIVE
  We evaluate laparoscopic nephrectomy for giant hydronephrosis with an emphasis on the operative technique of retroperitoneoscopic surgery.
  
  
  METHODS
  During the last 2 years 13 men and 5 women underwent laparoscopic nephrectomy for giant hydronephrosis via a transperitoneal (6) or retroperitoneal (12) approach. The etiology was congenital ureteropelvic junction obstruction in 17 patients and hydronephrosis caused by stone disease in 1. Three patients had a contralateral obstructed kidney. Renal parameters were normal in all patients.
  
  
  RESULTS
  All procedures were successfully completed without the need for conversion to open surgery. Mean operating time was 113.8 minutes (range 70 to 165) and average blood loss was 260 ml. (range 40 to 600). No patient required a blood transfusion. Postoperative recovery was uneventful with an average postoperative hospital stay of only 3.2 days (range 2 to 5).
  
  
  CONCLUSIONS
  Laparoscopic nephrectomy is a good alternative to open surgery for giant hydronephrosis and significantly reduced the morbidity of surgery. A retroperitoneal approach is feasible, despite the large amount of retroperitoneal space occupied by these hugely dilated kidneys. Modifications of our technique have been invaluable to the successful outcome in this series.
authors.affiliation: Department of Urology, All India Institute of Medical Sciences, New Delhi.
authors.forename: A K
authors.initials: AK
authors.lastname: Hemal
authors.forename: S N
authors.initials: SN
authors.lastname: Wadhwa
authors.forename: M
authors.initials: M
authors.lastname: Kumar
authors.forename: N P
authors.initials: NP
authors.lastname: Gupta
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology / Q000601:surgery*; D007682:Kidney Pelvis; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D010537:Peritoneum; D014517:Ureteral Obstruction / Q000150:complications / Q000601:surgery*