Complications of laparoscopic renal surgery

Laparoscopic renal surgery has become a standard of care over the past decade worldwide. Although more complex laparoscopic renal procedures are being routinely performed worldwide today, complications can occur with any laparoscopic operation. Intraoperative and postoperative complications may occur in patients undergoing laparoscopic renal procedures by urologic surgeons with all degrees of laparoscopic experience. We reviewed the complication rate in patients undergoing laparoscopic renal procedures at a single institution by an experienced laparoscopic surgeon.

We retrospectively reviewed the electronic medical records of patients who underwent laparoscopic renal surgery at the University of Iowa from August 2001 to November 2008.

Four hundred twenty-one consecutive laparoscopic renal operations were performed by a single surgeon, consisting of 168 radical nephrectomies, 99 donor nephrectomies, 52 simple nephrectomies, 66 partial nephrectomies, and 36 nephroureterectomies, with a total of 52 complications (12.3%): 20 (11.9%) for radical nephrectomy, 9 (9%) for donor nephrectomy, 3 (5.8%) for simple nephrectomy, 12 (18.2%) for partial nephrectomy, and 8 (22.2%) for nephroureterectomy. The vast majority of complications were minor and resulted in no residual disability.

Despite its advantages, laparoscopic renal surgery is not without its inherent risk of complications for the patient, and a thorough informed consent is crucial to maintain realistic patient expectations. Our results reveal complication rates comparable to those of published series in the literature.