Laparoscopic nephropexy.
OBJECTIVE
We evaluated the safety and efficacy of laparoscopic nephropexy for symptomatic nephrotosis.


METHODS
Between May 2000 and December 2005, 6 women (mean age, 43.1 years) underwent laparoscopic nephropexy of 8 kidneys (6 right, 2 left). Mean body mass index was 19.6 kg/m(2). Two patients displayed ureteropelvic junction obstruction (UPJO). Preoperative evaluation was performed by intravenous urography (IVU) and isotope renography in both the supine and erect positions. Four patients (6 renal units) underwent retroperitoneoscopic nephropexy, with a dismembered pyeloplasty in 1 patient (1 renal unit). The transperitoneal approach was performed in 2 patients, the first case and another with UPJO due to an aberrant vessel. The kidney was mobilized, then fixed to the back muscles with nonabsorbable sutures.


RESULTS
Mean operative time was 139.4 minutes (range, 95-200), and mean blood loss was 30 mL (range, 10-60). No perioperative complications were encountered. Mean hospital stay was 6.4 days. Postoperative IVU and isotope renography correctly confirmed a fixed kidney and no obstruction in the UPJO cases. All patients reported a symptomatic improvement during follow-up (range, 11-81 months).


CONCLUSIONS
As pain is the presenting symptom in these cases, a laparoscopic approach seems to represent the gold standard for treatment owing to low morbidity and good cosmetic results.
El-Moula
Mohamed Gad
MG
Department of Urology, The University of Tokushima Graduate School of Medicine, Institute of Health Biosciences, Tokushima, Japan.
Izaki
Hirofumi
H
Kishimoto
Tomoteru
T
Takahashi
Masayuki
M
Fukumori
Tomoharu
T
Kanayama
Hiro-omi
HO
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D013520:Urologic Surgical Procedures / Q000379:methods*