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Laparoscopic renal biopsy: a 9-year experience.
K R Shetye1, L R Kavoussi, S Ramakumar
1Division of Nephrology, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
BJU International
|June 5, 2003
Summary
Laparoscopic renal biopsy is a safe and effective minimally invasive option when percutaneous biopsy is not feasible. This procedure yields adequate tissue for diagnosis with short recovery times for most patients.
Area of Science:
- Nephrology
- Minimally Invasive Surgery
- Diagnostic Procedures
Background:
- Renal biopsy is crucial for diagnosing proteinuria, hematuria, and renal failure.
- Percutaneous biopsy is the standard, but contraindications exist.
- Laparoscopic renal biopsy offers a minimally invasive alternative.
Purpose of the Study:
- To evaluate the experience and outcomes of laparoscopic renal biopsy over a 9-year period.
- To assess the safety and efficacy of this technique.
- To highlight its utility when percutaneous biopsy is not an option.
Main Methods:
- A retroperitoneal laparoscopic approach was used in 74 patients.
- Indications included morbid obesity, solitary kidney, coagulopathy, and failed percutaneous biopsy.
- Cortical biopsies were obtained using cup-biopsy forceps under direct vision.
Main Results:
- Adequate tissue for diagnosis was obtained in 96% of patients.
- Mean operative time was 123 minutes, with a mean blood loss of 67 mL.
- Complications occurred in 10 patients, including significant bleeding in three; one patient died post-operatively.
Conclusions:
- Laparoscopic renal biopsy is a safe and effective alternative for patients unsuitable for percutaneous biopsy.
- It allows direct visualization for hemostasis and cortical tissue acquisition.
- The procedure generally results in adequate tissue yield and short patient recovery.