Laparoscopic Nephropexy: The Sliding Clip Technique

Nephroptosis is a clinical condition characterized by symptoms related to an abnormal caudal movement of the kidney. During the past decade, the availability of laparoscopic surgery has led to a revival of interest in nephroptosis. Most of the traditional surgical techniques aim to achieve kidney fixation by placing triangulation sutures between the abdominal wall and the renal capsule. These sutures are often difficult to tie because of the confined working space. We herein present a case of a 31-year-old female patient who presented with symptomatic right-sided nephroptosis and was managed effectively by laparoscopic nephropexy. We have applied a technical modification to facilitate laparoscopic fixation by utilizing suture and nonabsorbable polymer clips ("sliding clip" technique). Laparoscopic nephropexy is a safe and effective procedure for the management of symptomatic nephroptosis. The "sliding clip" technique is a modification familiar to most urologists that facilitates intracorporeal suturing and adequate renal fixation.