Laparoscopic pelvic nephrectomy:  essential preoperative and intraoperative considerations.
Pelvic kidneys are typically asymptomatic, but surgical intervention may be required in select cases.  Laparoscopic pelvic nephrectomy is a feasible option.  Given the highly variable vascular anatomy, careful surgical planning and meticulous technique are necessary.  We present our experience with this minimally invasive approach.  A 46-year-old male with a painful, non-functioning left pelvic kidney initially underwent left ureteral stent placement.  He was noncompliant and lost to follow up.  He re-presented and elected for laparoscopic pelvic nephrectomy.  The procedure was performed without complications.  Key features included detailed preoperative vascular imaging, ureteral catheterization, optimal port placement, and dissection from a cephalad to caudal direction.  Laparoscopic nephrectomy is a safe and efficacious treatment for diseased pelvic kidneys.
Department of Urology, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA.
Kelly A
KA
Healy
Andrew
A
Margules
Chandan
C
Kundavaram
Scott G
SG
Hubosky
Costas D
CD
Lallas
D006801:Humans; D007668:Kidney / Q000002:abnormalities / Q000000981:diagnostic imaging* / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D010388:Pelvis; D011300:Preoperative Care; D011859:Radiography