Laparoscopic nephropexy: Treatment outcome and quality of life

Abstract

INTRODUCTION: Surgical treatment of nephroptosis is rarely performed nowаdays and is done only in symptomatic patients. Here we present the results of our laparoscopic nephropexy in patients with symp­tomatic nephroptosis.

MATERIALS AND METHODS: For a period from March 2014 to March 2015, a total of 8 women at an av­erage age of 54 years were operated on in our clinic . Four of the patients were with nephroptosis of the left kidney, three of the right one and one had bilateral nephroptosis. Most of the patients complained of pain and discomfort in active movement, only one individual had complaints consisting of intermittent macro­scopic hematuria. One patient had been operated on in the past by a classic open method of the same kidney. Preoperatively, for all patients, intravenous urography in supine and standing position was performed. All patients were operated on trans-peritoneally through 3 ports: 1x10 mm and 2x5 mm. The kidney was com­pletely mobilized and kidney fat was dissected. The upper and middle pole of the kidney were fixed to mus­culus psoas major, using a single non-absorbable suture and intracorporeal technique for tying.

RESULT: All operations were performed with minimal blood loss, an average operating time of 45 minutes and a hospital stay of 4 days. No conversion was required in any of the cases. Postoperatively, patients were tracked and monitored by ultrasound examination. At 3 months we did IVP, which showed the correct loca­tion of the kidney. All patients remained asymptomatic for an average of 11 months after surgery.

CONCLUSION: Laparoscopic transperitoneal nephropexy is a safe and effective procedure and a promising method for correction of symptomatic nephroptosis.