Sel̇im Böbrek Hastaliklarinda Retroperitoneal ve Transperitoneal Laparoskopik Nefrektomi

Introduction: Laparoscopic procedures gain its places in all kind of surgery also in contemporary urology practice, because of its minimal postoperative morbidity and shorter convalescence. Laparoscopic nephrectomy is often performed trough the transperitoneal approach because it provides clear anatomic landmarks and a larger working space. The aim of the study is to evaluate the results of the laparoscopic nephrectomy procedures on benign indications. Material and Methods: Between September 2000 and June 2002, 14 operations of laparoscopic nephrectomy, from two different hospitals, performed by the same surgical team, were evaluated in terms of efficacy, safety and possible complications of the technique. Results: Mean age of the patients was 36,6 (range 14-68) and female, male ratio was 8/6. Preoperative diagnoses were hydronephrosis in 3 patients, atrophic kidney in 6 patients and atrophic kidney with kidney stone in 5 patients. 6 patients were subjected to right nephrectomy and left-sided nephrectomy was performed on the rest. Nephrectomy was performed transperitoneally (8 patients) or retroperitoneally (6 patients). Mean duration of operation was 132 minutes (range 95-165 minutes). There was no need to conversion to open surgery and no need to use drain except one patient with a huge hydronephrotic kidney. Mean hospitalization time was 2 days (1-4 days). There was no peroperative or postoperative complications detected in any patient, Conclusion: Laparoscopic nephrectomy is a minimally invasive technique regarding to the comparable efficacy, safety and limited rate of complication rate with open surgery in the surgical treatment of kidney diseases. As a matter of fact laparoscopy in urology is still a center-related procedure and even in these centers only a minority of urologists practice laparoscopy. However, in experienced centers the laparoscopic technique should be offered to patients to whom offered elective nephrectomy. The most important advantages of laparoscopic nephrectomy are less analgesic consumption, shorter convalescence and minimal cosmetic defect.