Single incision right nephrectomy for severe hydrophrenosis in a transplanted patient
Epublication WebSurg.com, Jul 2010;10(07). URL: http://websurg.com/doi/vd01en3017
Laparoscopy is becoming the "gold standard" approach for nephrectomy when treating different benign and malignant diseases as well as for living donor transplantation. During the last few months in both experimental and clinical settings, new techniques such as Natural Orifice Transluminal Endoscopic Surgery (NOTES™) and Single Incision Laparoscopic Surgery (SILS) or Single Port Laparoscopic Surgery (SPLS) have been attempted in order to reduce even more the surgical trauma in laparo-endoscopic procedures. SPLS allows to perform different surgical procedures using the umbilicus as the only site to access the abdominal cavity and, by using special trocars and instruments, to perform the operation using the same techniques and principles of standard laparoscopic surgery. The video describes our personal technique for totally single incision right nephrectomy for severe hydronephrosis in a patient who has undergone a kidney transplant a few years earlier. A 62-year-old patient underwent a kidney transplant 5 years earlier due to a renal failure caused by a glomerular nephritis. The native kidneys were left in place. Several admissions of patients presenting with recurrent sepsis were reported to the infectious disease department. Recurrent sepsis was likely to be caused by the hydronephrosis induced by a large stone located in the middle part of the ureter. The abdominal MRI showed the severe hydronephrosis of the native right kidney as well as a large stone. A single incision nephrectomy was performed with no complications and the patient’s postoperative course was uneventful.