INITIAL EXPERIENCES WITH THE RETROPERITONEAL APPROACH FOR ENDOSCOPIC NEPHRECTOMY WITH THE PATIENT IN THE PRONE POSITION

Retroperitoneal endoscopic nephrectomy with the patient in the prone p osition was performed in 12 patients. Indications for this procedure w ere end-stage kidneys with ureteropelvic junction stenosis or distal u reteric obstruction, nonfunctional kidneys with drug resistant renin-m ediated hypertension, and distal ureter malignancy. The retroperitonea l area was exposed using an open surgical technique in combination wit h the use of a liquid-filled dissection balloon. Removal of kidney tis sue was performed with a morcellator through one of the ports. On aver age, the operating time was 210 min (range 160-480 min) to complete a one-sided nephrectomy. No major complications occurred. Mean hospital stay in this series was 6.6 days, and the follow-up period was uncompl icated in all cases. Retroperitoneal endoscopic nephrectomy with the p atient in the prone position is an acceptable alternative to open neph rectomy in selected indications.