Laparoscopic nephrectomy with transvaginal extraction of the kidney. The first case performed in Romania – national premiere

T.S. Pătrăşcoiu, C. Roşulescu, E. Brătilă, I. Prie, L. Popa, C. Pătrăşcoiu, N. Copca

Rezumat: Introduction and objective. We present the case of a 32-yearold female patient who presented in our department (Surgical Department II, “Sfânta Maria” Clinical Hospital, Bucharest) with hypertension due to a small kidney. CT scan revealed a small left kidney and malrotated right kidney, without other pathology; the creatinine level was 0.9 mg%, and renal scintigraphy showed less than 10% function for this kidney. We planned to do the first laparoscopic nephrectomy with transvaginal extraction of the specimen in our country, Romania. Method. We placed the patient in extended flank position. The approach was transperitoneal, with standard trocar placement. After the completion of the primary laparoscopic nephrectomy, we placed the specimen in Douglas pouch. The patient was placed in supine lithotomy position. A transverse posterior colpotomy was performed transvaginally at the apex of the fornix. The peritoneum was opened under laparoscopic view. The specimen was extracted intact transvaginally. The posterior colpotomy was repaired transvaginally. Results. The operative time was 90 minutes. Blood loss was minimal (less than 100 ml). No intraoperative or postoperative complications occurred. The patient was discharged after three days. Hypertension was controlled after nephrectomy without other antihypertensive drugs. The cosmetic aspect was excellent, and the sexual life was perfect after one month. Conclusions. Laparoscopic nephrectomy with transvaginal extraction of the kidney is a feasible and a cosmetically attractive technique, especially for young female patients
Cuvinte cheie: transvaginal surgery, laparoscopic nephrectomy, hypertension.