The not so 'simple' laparoscopic nephrectomy: Experience with 3D laparoscopy from a tertiary care centre

Area of Science:

• Urology
• Minimally Invasive Surgery
• Nephrology

Background:

• Laparoscopic simple nephrectomy (LSNx) is a standard surgical approach for managing poorly functioning or non-functioning kidneys (PFK/NFKs) of benign origin.
• Auditing perioperative outcomes and identifying associated factors is crucial for optimizing surgical planning and patient care.

Purpose of the Study:

• To audit perioperative outcomes of patients who underwent LSNx for benign causes.
• To analyze factors correlating with operative times and postoperative complications in LSNx.

Main Methods:

• A retrospective review of prospectively collected data from January 2017 to June 2023.
• Analysis of clinical, radiological, and perioperative details for 302 patients undergoing transperitoneal LSNx.

Main Results:

• Urolithiasis was the most common indication (66.5%). Conversion to open surgery occurred in 5.3% of cases.
• Pre-operative fat stranding, larger kidney size, Xanthogranulomatous pyelonephritis (XGPN), and pyonephrosis were linked to longer operative times.
• Prior renal surgery, positive urine culture, XGPN, and higher BMI correlated with increased hospital stay and complications.

Conclusions:

• LSNx is a frequently used procedure for PFK/NFKs, with urolithiasis being the primary indication.
• Specific clinico-radiological factors significantly influence operative duration and hospital stay, aiding in surgical planning and patient counseling.