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Transperitoneal laparoscopic nephrectomy in acute Grade 4 renal trauma with literature review and a note on some unusual complications


 Department of Urology and Transplantation Surgery, Smt. G. R. Doshi and Smt. K. M. Mehta Institute of Kidney Diseases and Research Centre, Dr. H. L. Trivedi Institute of Transplantation Sciences, Ahmedabad, Gujarat, India

Correspondence Address:
Rohan Satish Valsangkar,
Room No. 106, Department of Urology and Transplantation Surgery, Smt. G. R. Doshi and Smt. K. M. Mehta Institute of Kidney Diseases and Research Centre, Dr. H. L. Trivedi Institute of Transplantation Sciences, Civil Hospital Campus, Ahmedabad, Gujarat
India
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Source of Support: None, Conflict of Interest: None

Most renal traumas are successfully managed conservatively. Grade 4 and 5 trauma, however, can require nephrectomy which is almost always by laparotomy and laparoscopic nephrectomy (LN) is still considered contraindicated in acute trauma setting. We report successful transperitoneal LN in an acute grade 4 renal trauma with retroperitoneal haematoma, extensive parenchymal devascularisation and urinary extravasation though retroperitoneoscopic nephrectomy in trauma has been reported recently. However, we believe transperitoneal approach is more logical and replicates all the principles of open renal trauma surgery more accurately. A review of LN in renal trauma and some unusual problems to be anticipated during laparoscopic procedures in acute trauma setting is presented.


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    -  Valsangkar RS
    -  Rizvi SJ
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2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04