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Laparoscopic ablation of peripelvic renal cysts
D M Hoenig1, E M McDougall, A L Shalhav
1Department of Radiology, Washington University, St. Louis, Missouri, USA.
Purpose:
We describe and define the operative techniques, findings and results of laparoscopic ablation of peripelvic renal cysts.
Materials And Methods:
One male and three female patients, ranging in age from 35 to 59 years, underwent laparoscopic ablation of symptomatic peripelvic cysts. All patients had symptoms of ipsilateral flank pain and obstruction. One patient had an episode of pyelonephritis before detection of the cyst, and 2 patients had concomitant stones within the obstructed system. Cysts ranged in size from 4 to 6 cm. Dissection was uniformly complex because of the depth to which the cyst extended into the renal parenchyma and the overlying renal vessels and collecting system.
Results:
Operative times ranged from 315 to 390 minutes (mean 338 minutes). The average length of hospital stay was 2.75 days (range 2 to 4 days). Three of 4 patients (75%) had resolution of their symptoms and collecting system obstruction. One patient, the only case of a retroperitoneal approach, had recurrence of her symptoms and cyst 2 months after the operation and required open surgical repair.
Conclusions:
Laparoscopic ablation of peripelvic cysts is a challenging yet feasible procedure. Because of the medial location of these cysts, a transperitoneal approach may be preferable to retroperitoneal access alone.