Efficiency of laparoscopic-assisted renal biopsy.
BACKGROUND
This study was made to present our experience and results with transperitoneal laparoscopic-assisted renal biopsy (LARB) in Nagoya University Hospital as a good alternative for open renal biopsy.


METHODS
21 patients (14 male, 7 female, mean age 58 years, range 21-83 years) were unsuitable for percutaneous renal biopsy. Therefore, they underwent laparoscopic-assisted renal biopsy. The kidney was approached transperitoneally via three ports, cortical tissue was obtained using a 16-gauge gun-mounted semiautomatic biopsy needle. Hemostasis was obtained by applying pressure on the renal puncture using gauze until bleeding had been stopped (range 5-20 min).


RESULTS
Adequate cortical tissue and accurate diagnoses were obtained in all patients. Mean operative time was 83 min (range 65-120 min) and mean estimated blood loss was 5.5 ml (range 1-10 ml). There were no intraoperative complications: no open conversion, blood transfusions or gross hematuria. All patients walked about freely and could tolerate regular food on the first postoperative day. The only postoperative complication was a hernia formation at the place of trocar insertion 3 months after the operation in one patient who previously underwent multiple surgery for 3 arterial grafts and appendicitis.


CONCLUSIONS
LARB is a safe and accurate procedure for obtaining cortical biopsies with minimal blood loss. Although LARB remains a surgical procedure which requires general anesthesia, LARB to date may be considered as a good alternative to open renal biopsy for patients in whom a closed percutaneous approach is either a relative or absolute contraindication.
Anas
C M
CM
Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan. japanas2002@hotmail.com
Hattori
R
R
Morita
Y
Y
Matsukawa
Y
Y
Komatsu
T
T
Yoshino
Y
Y
Maruyama
S
S
Yuzawa
Y
Y
Matsuo
S
S
Gotoh
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology*; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged