Transmesenteric approach for left transperitoneal renal surgery: technique and experience.
BACKGROUND
In the last few years laparoscopic surgery has become the gold standard for the treatment of several urological diseases such as renal cancer and ureteropelvic junction obstruction (UPJO). A transmesenteric approach for left laparoscopic pyeloplasty has been recently described in order to avoid bowel manipulation and the potentially related complications. The aim of the present study is to describe the surgical technique and the advantages of the transmesenteric approach for laparoscopic pyeloplasty, pyelolithotomy, and simple nephrectomy in our experience.


METHODS
From December 2007 to May 2010, 12 laparoscopic procedures for left renal diseases were performed using a transmesenteric approach. The indications were left UPJO in 9 cases, left pelvic-ureteral stones in 2 cases, and left end-stage kidney disease in one case.


RESULTS
No conversions or intraoperative complications were observed. No blood transfusions were required. Resumption of oral intake and canalization occurred in all cases within 48 hours of the procedure. All patients had an uneventful postoperative course.


CONCLUSIONS
The laparoscopic transmesenteric approach represents an interesting and advantageous technical improvement of minimally invasive surgery for the treatment of left renal diseases.
Division of Urology, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy.
Monica
M
Zacchero
Alessandro
A
Volpe
Michele
M
Billia
Roberto
R
Tarabuzzi
Francesco
F
Varvello
Paolo
P
De Angelis
Elisa
E
De Lorenzis
Irene
I
Mittino
Carlo
C
Terrone
D000328:Adult; D005260:Female; D006801:Humans; D007668:Kidney / Q000601:surgery*; D007674:Kidney Diseases / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008643:Mesentery; D008875:Middle Aged; D009392:Nephrectomy