Difficulties in Laparoscopic Urologic Surgery in Kidney Transplant Patients and Obese Patients
Laparoscopic surgery has become an established procedure for surgical management of most benign and malignant urologic conditions. Laparoscopic nephrectomy can be performed either by a transperitoneal or retroperitoneal approach. The complexity of the surgery directly relates to the chronic kidney disease (CKD) for which the surgery is to be performed. Laparoscopic interventions may be required in the following situations namely, pretransplant nephrectomy for stones in the native kidney, pyonephrosis, autosomal dominant polycystic kidney disease (ADPKD), pretransplant orchidectomy for an intra-abdominal testis, post-transplant lymphocoele marsupilisation and laparoscopic-assisted placement of a Tenckoff catheter. The approach to any given case is a matter of personal preference – it should be chosen depending on the comfort level of the surgeon.