Laparoscopic versus Lumboscopic Nephrectomy

Objectives : The aim of this study is to compare the initial experience at two different urologic centers of the 20 first laparoscopic nephrectomies performed either by transperitoneal laparoscopy (10 cases) in one center or by retroperitoneal laparoscopy (lumboscopy, 10 cases) in the other center. Methods: 5 males and 15 females with a mean age of 36 years (range 3-74) were operated on the right side in 8 cases and on the left side in 12 cases. Nephrectomies were indicated in 18 cases for benign renal disease, and in 2 cases for ureteric tumor (1 patient in each group). The techniques of these two approaches are described. Results : The mean operating time was shorter with lumboscopy (173 min) than with laparoscopy (210 min), probably due to the direct approach to the renal compartment without intraperitoneal dissection with lumboscopy. There were no severe intraoperative or postoperative complications, but one hematoma of the renal area in the laparoscopic group. The mean postoperative hospital stay was identical following lumboscopy and laparoscopy (4.3 and 4.2 days, respectively). Conclusion : These two approaches can be used to perform nephrectomy. In this initial experience, the results appear to be equivalent in terms of morbidity and postoperative hospital stay, but the operating time appears to be shorter with lumboscopy. Larger studies comparing respective nephrectomy conversion rates would provide other arguments in favor of one or other of these techniques.