Retroperitoneal Laparoscopic Heminephrectomy for Duplex Kidney Anomaly

Duplex kidney is a congenital anomaly of urinary system with incidence rate of 0.8% [1]. Some patients with duplex kidney are asymptomatic, they can be followed up without active intervention. Heminephrectomy is one the recommended treatment for patients presenting with recurrent urinary tract infection or urinary incontinence [2]. After the first laparoscopic heminephrectomy was reported by Jordan et al. in 1993 [3], this surgery had been widely performed through either transperitoneal or retroperitoneal approach to treat duplex kidney [4, 5]. We prefer the retroperitoneal approach to avoid manipulation with intraperitoneal organs. In view of high risk of urinary leakage from heminephrectomy, we have modified heminephrectomy by excision of urothelium from upper moiety remnant and closure of upper moiety remnant. In our experience, this technique effectively prevents the postoperative urinary leakage.