Korean J Urol.  2007 Nov;48(11):1139-1142. 10.4111/kju.2007.48.11.1139.

Early Experience of Laparoscopic Nephropexy

• Seo IY
• Rim JS

• KMID: 1997090
• DOI: http://doi.org/10.4111/kju.2007.48.11.1139

Abstract

PURPOSE: We evaluated the feasibility of laparoscopic nephropexy for treating patients with symptomatic nephroptosis according to our early experiences.
MATERIALS AND METHODS
Between June 2005 and June 2006, 3 patients with nephroptosis underwent laparoscopic nephropexy. They presented with long-standing flank pain. Nephroptosis was confirmed with performing supine and erect excretory urography(EU). The mean age of the 3 women was 40.7 years old, and their mean body mass index was 19.3kg/m2. The mean length of the nephroptosis was 7.5cm on EU. The operation was performed with a 3 trocar system through the transperitoneal approach. The renal capsule and parenchyme were fixed to the fascia of the quadratus lumborum muscle using 2-0 black silk.
RESULTS
Laparoscopic nephropexy was performed successfully in all patients. The mean operative time was 58.3 minutes. There was no operative complication and transfusion. Initiation of the oral intake and ambulation took place on postoperative day 1. The mean hospital stay was 5.7 days. Flank pain disappeared in 2 patients, and it was decreased in one patient for the 17.7 months of the mean follow-up. The mean length of the nephroptosis was 3.0cm on postoperative EU.
CONCLUSIONS
Laparoscopic nephropexy for treating symptomatic nephroptosis could be performed easily and safely with an excellent outcome.

Keyword

Laparoscopy; Kidney; Kidney diseases

MeSH Terms

Body Mass Index
Fascia
Female
Flank Pain
Follow-Up Studies
Humans
Kidney
Kidney Diseases
Laparoscopy
Length of Stay
Operative Time
Silk
Surgical Instruments
Walking
Silk

Figure

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  Fig. 1 Trocar positioning for the right laparoscopic nephropexy. A: 5/11mm trocar for laparoscope, B: 5/11mm trocar, C: 5mm trocar.

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  Fig. 2 Intracorporeal sutures for renal fixation. A needle with 2-0 silk was stitched into the renal capsule and parenchyme at the superior and lateral borders (A). It was placed into the fascia of the quadratus lumborum (B).

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