Retroperitoneoscopic nephrectomy for autosomal dominant polycystic kidney disease: initial experience.
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.
Wyler
Stephen F
SF
Department of Urology, University Hospital Basel, Basel, Switzerland. swyler@uhbs.ch
Bachmann
Alexander
A
Ruszat
Robin
R
Forster
Thomas
T
Hudolin
Tvrtko
T
Gasser
Thomas C
TC
Sulser
Tullio
T
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