Simultaneous bilateral simple nephrectomy

Bilateral simultaneous nephrectomy is a rare procedure usually performed for end-stage renal disease, most often because of persistent hypertension after renal transplantation. Four trocars generally are inserted, with a lower abdominal and a subcostal port being used by the surgeon. An intra-abdominal pressure of 8 to 10 mm Hg is used during the procedure. The first kidney is left in situ while the other one is being dissected. Unless there is infection or malignancy, a retrieval sac is not used. In our series of 13 cases, the operating times ranged from 240 to 390 minutes (mean 320 minutes), and the mean 125 mL. Surgical discharges criteria usually were met on postoperative day 1 or 2. Laparoscopic bilateral nephrectomy in a single session is feasible in nearly all properly selected cases, even in patients with previous abdominal surgery or peritoneal dialysis. The operation takes longer than open surgery and may have a higher complication rate, but recovery is faster.