Laparoscopic Transperitoneal Simple, Radical and Partial Nephrectomy: A Single Center Experience

Objective: To present our initial experience on laparoscopic transperitoneal nephrectomies and to report the perioperative and postoperative outcomes in patients with kidney tumor. Materials and Methods: We retrospectively evaluated clinical data, laboratory results and radiological findings of 40 patients who underwent laparoscopic renal surgery performed by a single surgeon in a single center between November 2017 and May 2019. Thoracoabdominopelvic computed tomography was performed in all patients. Results: A total of 40 patients (26 males (65%), 14 females (35%) with a median age of 58.7 years underwent laparoscopic transperitoneal nephrectomy. Sixteen patients underwent laparoscopic simple nephrectomy (LSN) for nonfunctional kidney, 20 patients with solid renal tumors underwent laparoscopic radical nephrectomy (LRN), and four patients underwent laparoscopic partial nephrectomy (LPN) for solid renal mass. The mean operative time was 207.9 +/- 79.1, 218.9 +/- 57.5 and 175.0 +/- 75.0 minutes for LSN, LRN and LPN, respectively. The mean length of hospital stays was 3.0 +/- 1.3, 2.7 +/- 0.6 and 2.7 +/- 1.5 days, respectively. Conversion to open surgery was done in 2 patients who underwent LRN and in two patients who underwent LSN due to intraoperative bleeding and intraperitoneal adhesions, respectively. We experienced postoperative complication only in one patient (2.5%) who underwent LSN. Conclusion: Advances in technology and surgical experience have led to an increase in laparoscopic kidney surgery even for advanced renal tumors. Serious complications may occur mainly in the early stages of the learning curve, but complication rates and operative time significantly decrease by the surgeons' experience. Complicated and more extensive tumors make surgeons more experienced in advanced laparoscopic treatment techniques.