Retroperitoneoscopic renal biopsy: still a good indication!

Area of Science:

• Nephrology
• Minimally Invasive Surgery
• Renal Histopathology

Background:

• Histological evaluation of renal parenchyma is crucial for diagnosing and managing renal diseases.
• Percutaneous kidney biopsy is a standard diagnostic tool.
• Retroperitoneal laparoendoscopic single-site surgery (LESS) presents a minimally invasive alternative for patients with contraindications to percutaneous biopsy.

Observation:

• LESS technique poses challenges, particularly regarding the learning curve and surgical difficulty.
• A Jehovah's Witness patient with severe obesity presented with contraindications for percutaneous renal biopsy.
• The patient's specific clinical profile, including severe obesity, complicated the feasibility of the LESS approach.

Findings:

• Conventional retroperitoneal laparoscopic renal biopsy was deemed more suitable than LESS for this specific patient.
• The decision prioritized patient safety and procedural success over the adoption of a less established minimally invasive technique.

Implications:

• This case highlights the importance of individualized surgical approach selection in renal biopsy.
• Challenges associated with LESS technique, such as the learning curve and patient-specific factors, must be considered.
• Conventional laparoscopic techniques remain a valuable option when advanced minimally invasive approaches are not optimal.