V2-14: Laparoscopic heminephrectomy for a non-functioning lower moiety
VideoIntroductions and Objectives
Magnification and delicate handling gave laparoscopy a good share in management of pathologies related to renal duplicity because such qualities aid in preservation of the blood supply to the intact moiety together with its ureter. This video demonstrates the technique of transperitoneal laparoscopic heminephrectomy for a hydronephrotic non-functioning lower moiety of a duplex Lt kidney.
thirty-three years old male patient, presented with loin pain, hematuria and fever one month after blunt trauma to the left loin. Multidetector CT showed a hugely dilated lower moiety of the left kidney with turbid content and a stone in its draining ureter. Retrograde uretero-pyelography showed incomplete duplication of the ureter. Double J stent was inserted in the ureter of the upper moiety. A transperitoneal laparoscopic approach with 4 trocars was adopted.
operative time was 180 minutes with minimal blood loss and no intraoperative complications. The tube drain was removed on the 3rd PO day and the patient was discharged on the 4th.
The magnification of laparoscopy made it possible to identify the bifurcation of the ureters despite of adhesions and to secure the supplying twigs to the lower moiety without trauma to the main pedicle or the blood supply of the upper moiety.