Minilaparotomy for internal drainage of a symptomatic lymphocele after renal transplantation

Development of a lymphocele after renal transplantation is a well-described complication that occurs with relative frequency. Management options include simple aspiration with sclerotherapy and operative marsupialization of the lymphoceles into the peritoneal cavity. Laparoscopic internal drainage has been favored in recent reports. Still, the laparoscopic procedure is associated with a number of potential problems, including difficulty in localizing lymphoceles if laparoscopic ultrasound is unavailable. In addition, lobulated lymphoceles are more difficult to completely dissect with laparoscopy, and lymphoceles always occur on the anterior and medial aspects of the graft which are easily approached directly from the anterior skin. We tried to resolve these complications by modifying traditional laparotomy and proved that laparoscopy is a progressive, popular procedure, and that fenestration with finger dissection of the lobulated lymphoceles through minilaparotomy is still a reliable, effective procedure.