title: Laparoscopic bilateral hand-assisted nephrectomy: end-stage renal disease from tuberculosis, an unusual indication for nephrectomy before transplantation.
abstract: The purpose of the study was to sterilize renal tuberculous foci in a pretransplantation patient with a laparoscopic hand-assisted approach and to verify the feasibility of bilateral nephrectomy for this indication. This case report is the first description of hand-assisted laparoscopic bilateral nephrectomy for this pathologic condition. The 33-year-old patient had end-stage renal disease from renal tuberculosis. A commercially available hand-assistance device was used through a midline 8-cm supraumbilical incision and with four ports. The procedure was successfully completed. The total operative time was 3 hours and 40 minutes. Estimated blood loss was 250 mL. The postoperative course was uneventful, and clinical follow-up at 3 weeks revealed a successful outcome. Hand-assisted bilateral laparoscopic nephrectomy in patients with chronic renal failure from tuberculosis represents a viable option because it is feasible and effective. The hand-assisted approach increases the safety of the procedure while retaining all the advantages of minimally invasive surgery.
authors.affiliation: Advanced Laparoscopic Unit, Department of General Surgery and Transplant, San Martino Hospital, University of Genoa, Monoblocco IVo piano, Largo Rosanna Benzi no 10, 16132 Genoa, Italy. Narco.Casaccia@unige.it
authors.forename: Marco
authors.initials: M
authors.lastname: Casaccia
authors.forename: Paolo
authors.initials: P
authors.lastname: Torelli
authors.forename: Iris
authors.initials: I
authors.lastname: Fontana
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Panaro
authors.forename: Umberto
authors.initials: U
authors.lastname: Valente
mesh_terms: D000328:Adult; D005260:Female; D006225:Hand; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology* / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D016031:Liver Transplantation / Q000379:methods*; D009392:Nephrectomy / Q000379:methods*; D011300:Preoperative Care / Q000379:methods; D014398:Tuberculosis, Renal / Q000150:complications* / Q000601:surgery*