Between May 2003 and May 2006, 60 laparoscopic
nephrectomies were performed by a single surgeon. Laparoscopic route for
nephrectomy was retroperitoneal in 50 cases and transperitoneal in 10 cases.
RESULTS: The patients included 37 males and 23 females. The mean age was 18.5 +/- 16.6 years and ranged from 2 years to 60 years. Right sided
nephrectomy was performed in 31 cases while left kidney was removed in 29 cases. The indications for
nephrectomy were stones (n = 29), dysplasia (n = 11), chronic
pyelonephritis (n = 8),
pelvi ureteric junction obstruction (n = 4),
tuberculosis (n = 3), vesicoureteric reflux (n = 3) and
ureterocele(n = 2). Mean operating time for laparoscopic
nephrectomy alone was 140 +/- 51.1 min (range 25-300 minutes). In our series, 19 additional
surgical procedures were performed under the same general anaesthesia. The mean
hospital stay for all patients was 3.1 +/- 2.39 days; however the mean
hospital stay for those patients who underwent laparoscopic
nephrectomy without any additional procedure is 2.2 +/- 0.92 days (1.5-4 days). The mean size of kidney removed was 7.4 +/- 3.13 cm (4.6-15.9 cm). Complications were seen in 2 patients (3%); one developed
wound infection and the other was found to have a haematoma for which the
wound was re-explored. Conversion to open
nephrectomy was required in 7 patients (11.6%) due to
bleeding from renal pedicle (n = 4), poor vision secondary to
pus spillage from pyonephrotic kidney (n = 2) and failure to progress due to indwelling percutaneous nephrostomy. There was no mortality and none of the patients had prolonged
ileus.
Blood transfusion was not required in any case. There was no bowel injury or port site herniation.
CONCLUSION: