Technique of laparoscopic nephrectomy in a patient with previous urinary diversion

Laparoscopic nephrectomy is quickly becoming accepted as the standard treatment for small renal neoplasms and benign renal disease. The presence of an ileal conduit has been termed a relative contraindication to laparoscopic surgery. A 58-year old female presented with recurrent pyelonephritis and hydronephrosis of her left kidney. Surgical removal was necessary and we considered a transperitoneal laparoscopic nephrectomy for her. The patient had an ileal conduit and it was because of this reason that only after careful consideration was it decided to attempt the surgery using the laparoscopic approach. We present our technique of transperitoneal laparoscopic nephrectomy in this patient with an ileal conduit and include technical suggestions that will help predict a successful outcome. The success of this case demonstrates that in certain circumstances, patients with urinary diversions can be offered laparoscopic nephrectomy and its benefits.