Laparoscopic pelvic nephrectomy: essential preoperative and intraoperative considerations

Pelvic kidneys are typically asymptomatic, but surgical intervention may be required in select cases. Laparoscopic pelvic nephrectomy is a feasible option. Given the highly variable vascular anatomy, careful surgical planning and meticulous technique are necessary. We present our experience with this minimally invasive approach. A 46-year-old male with a painful, non-functioning left pelvic kidney initially underwent left ureteral stent placement. He was noncompliant and lost to follow up. He re-presented and elected for laparoscopic pelvic nephrectomy. The procedure was performed without complications. Key features included detailed preoperative vascular imaging, ureteral catheterization, optimal port placement, and dissection from a cephalad to caudal direction. Laparoscopic nephrectomy is a safe and efficacious treatment for diseased pelvic kidneys.