title: Retroperitoneoscopic nephrectomy for autosomal dominant polycystic kidney disease: initial experience.
abstract: BACKGROUND
  Nephrectomy for autosomal dominant polycystic kidney disease (ADPKD) has been reported to have significant morbidity and mortality. Because of the large kidney size, laparoscopic nephrectomy is technically demanding and there have been only few reports on this subject. We describe our retroperitoneoscopic technique and review the literature.
  
  
  METHODS
  Retroperitoneoscopic nephrectomy was performed in 2 patients. A four-port retroperitoneal access was used, after hilar control the kidney was freed and extracted.
  
  
  RESULTS
  The mean operative time was 155 min, the mean intraoperative blood loss was 125 ml. There were no intraoperative complications. A postoperative retroperitoneal hematoma in 1 of the patients was managed conservatively with transfusion.
  
  
  CONCLUSIONS
  Retroperitoneoscopic nephrectomy for ADPKD is feasible. The main advantages of this technique compared to transperitoneal laparoscopy are the quick and easy access to the hilar vessels even in large polycystic kidneys and the strict extraperitoneal route.
authors.affiliation: Department of Urology, University Hospital Basel, Basel, Switzerland. swyler@uhbs.ch
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Wyler
authors.forename: Alexander
authors.initials: A
authors.lastname: Bachmann
authors.forename: Robin
authors.initials: R
authors.lastname: Ruszat
authors.forename: Thomas
authors.initials: T
authors.lastname: Forster
authors.forename: Tvrtko
authors.initials: T
authors.lastname: Hudolin
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Gasser
authors.forename: Tullio
authors.initials: T
authors.lastname: Sulser
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D016891:Polycystic Kidney, Autosomal Dominant / Q000601:surgery*; D012187:Retroperitoneal Space