[Retroperitoneal endoscopic nephrectomy].
OBJECTIVE
Nephrectomy is probably the most widely accepted procedure for the application of laparoscopic techniques in urology. The great advantages of laparoscopy over conventional approaches have justified its indication for different renal extirpative procedures: atrophy, renal carcinoma, transitional cell carcinoma, polycystic kidney disease, living kidney donation for transplantation and partial nephrectomies. The objective of this article is to describe the techniques and advantages of laparoscopic nephrectomy through a retroperitoneoscopic approach, demonstrating that it is an effective option for the majority of cases in which extraction of the kidney is required.


METHODS
Between January 1991 and January 2001 107 patients with different renal conditions were treated at the Instituto Docente de Urología (IDU) using transperitoneal (36 patients) or retroperitoneal (71 patients) laparoscopic access. Indications for laparoscopic approach included atrophy, living donation, renal carcinoma, urothelial tumour, polycystic kidney disease and partial nephrectomy.


RESULTS
Nephrectomy trough a transperitoneal approach was completed in 33 (91.6%) of 36 patients, being necessary to convert to conventional surgery in the remaining 3 cases (8.3%). Retroperitoneoscopic approach was successful in all cases (100%).


CONCLUSIONS
The retroperitoneoscopic approach is a simple procedure that allows its implementation in the majority of patients in which there is an indication for nephrectomy. Retroperitoneoscopy provides a rapid recovery, minimal analgesic needs, and a short hospital stay. Finally, retroperitoneoscopic approach represents a logical evolution for conventional flank incisions, providing familiarity with surgical field landmarks and management to those urologists that incorporate this new technical modality.
Escovar Díaz
Paúl Antonio
PA
Instituto Docente de Urología Avenida Carabobo c/c calle Carabobo Valencia-Estado Carabobo Venezuela. paulidu@cantv.net.ve, info@idu.com.ve
García Sanz
José Luis
JL
Escovar La Riva
Paúl Ernesto
PE
Rodríguez Escovar
Fernando Paúl
FP
Escobar
Antonio
A
Rey Pacheco
Manuel
M
López Escalante
Juan Ricardo
JR
Sánchez
Pablo Emilio
PE
Cuervo Arias
Rafael
R
Montilla
José Gregorio
JG
D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D019520:Living Donors; D009392:Nephrectomy / Q000295:instrumentation / Q000379:methods*; D007690:Polycystic Kidney Diseases / Q000601:surgery; D011187:Posture; D011300:Preoperative Care; D012187:Retroperitoneal Space; D013525:Surgical Instruments; D020858:Tissue and Organ Harvesting / Q000379:methods; D014057:Tomography, X-Ray Computed; D014513:Ureter / Q000601:surgery