title: Percutaneous endoscopic nephropexy with a percutaneous suture passed through the kidney.
abstract: OBJECTIVE
  To report a technique of percutaneous endoscopic nephropexy, using a polyglactin suture passed through the kidney, in patients with nephroptosis.
  
  
  METHODS
  Four women presenting with symptomatic right nephroptosis underwent a percutaneous endoscopic nephropexy. An upper-pole calyx was accessed percutaneously and a 24-F working sheath was placed. Another needle access was made through a lower-pole calyx and a #2 polyglactin suture was passed into the renal pelvis. It was then pulled out through the upper-pole tract using the nephroscope. A retroperitoneoscopy was performed and the tip of the nephroscope was used to cause nephrolysis. After inserting the nephrostomy tube the polyglactin suture was passed into the subcutaneous tissue and then tied without too much tension, to avoid cutting the parenchyma.
  
  
  RESULTS
  The operative duration was 33 min and the hospital stay after surgery was 3.5 days. The nephrostomy catheter was removed 5 days after surgery. There were no complications, especially no haemorrhagic, infectious, lithiasic or thoracic complications. The four patients were relieved of their initial symptoms, with a mean follow-up of 28 months. Ultrasonography and/or intravenous urography showed the kidney at a higher location with the patient standing.
  
  
  CONCLUSIONS
  This technique combines the nephrostomy tract used in percutaneous techniques with the suture and nephrolysis used in laparoscopic techniques. Moreover, this procedure seems to be safe, with satisfactory anatomical and clinical results and a lower morbidity. However, a larger series will be necessary to establish its long-term morbidity and success rate.
authors.affiliation: Department of Urology, Military Hospital Moulay Ismail, Meknes, Morocco.
authors.forename: M
authors.initials: M
authors.lastname: Lezrek
authors.affiliation: Department of Urology, Military Hospital Mohamed V, Rabat, Morocco.
authors.forename: Y
authors.initials: Y
authors.lastname: El Harrech
authors.affiliation: Department of Urology, Military Hospital Moulay Ismail, Meknes, Morocco.
authors.forename: K H
authors.initials: KH
authors.lastname: Bazine
authors.affiliation: Department of Urology, Military Hospital Mohamed V, Rabat, Morocco.
authors.forename: J
authors.initials: J
authors.lastname: Sossa
authors.affiliation: Department of Urology, Military Hospital Moulay Ismail, Meknes, Morocco.
authors.forename: M
authors.initials: M
authors.lastname: Assebane
authors.affiliation: Department of Urology, Military Hospital Moulay Ismail, Meknes, Morocco.
authors.forename: M
authors.initials: M
authors.lastname: Alami
authors.affiliation: Department of Urology, Military Hospital Moulay Ismail, Meknes, Morocco.
authors.forename: E H
authors.initials: EH
authors.lastname: Kasmaoui
authors.affiliation: Department of Urology, Military Hospital Moulay Ismail, Meknes, Morocco.
authors.forename: A
authors.initials: A
authors.lastname: Beddouch
authors.affiliation: Department of Urology, Military Hospital Mohamed V, Rabat, Morocco.
authors.forename: A
authors.initials: A
authors.lastname: Ameur
keywords: Kidney; Lateral modified position; Nephropexy; Nephroptosis; Percutaneous surgery