title: Hand-assisted bilateral nephrectomy in a patient with adult polycystic kidney disease.
abstract: BACKGROUND
  Dominantly autosomal polycystic disease is characterized by multiple bilateral and non-functional cysts, which lead to progressive kidney failure.
  
  
  OBJECTIVE
  Our objective was to report on a case of hand-assisted bilateral nephrectomy in a 28-year-old female patient with adult polycystic disease and recurring pyelonephritis in a kidney transplant program.
  
  
  METHODS
  A hand-assisted bilateral nephrectomy was performed through a supra-umbilical median incision of approximately 6 cm, and with 3 ports of 10 mm. The length of the surgery was 3 hours and 15 minutes. The kidneys were removed after the aspiration of some cysts through the supra-umbilical incision. Pain control was achieved via the use of analgesics. The blood loss during surgery was 160 ml. During the postoperative period, the patient developed right-side pneumothorax, which was drained with no further occurrence. This drain was kept in place for 48 hours. The length of hospitalization was 4 days.
authors.affiliation: Faculdade de Medicina, Fundaço ABC, São Paulo, Brazil. dmalvesp@terra.com.br
authors.forename: Marcello Alves
authors.initials: MA
authors.lastname: Pinto
authors.forename: Roberto Vaz
authors.initials: RV
authors.lastname: Juliano
authors.forename: Marcos
authors.initials: M
authors.lastname: Tobias-Machado
authors.forename: Milton
authors.initials: M
authors.lastname: Borrelli
authors.forename: Eric Roger
authors.initials: ER
authors.lastname: Wroclawski
mesh_terms: D000328:Adult; D005260:Female; D006225:Hand; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D009392:Nephrectomy / Q000379:methods*; D016891:Polycystic Kidney, Autosomal Dominant / Q000601:surgery*