Preliminary Experience of Laparoscopic Nephrectomy in Saudi Arabia

Aim of Study: To demonstrate our preliminary experience on laparoscopic nephrectomy at the Urology Department of the Armed Forces Hospital-Southern Region (AFH-SR), Saudi Arabia. Patients and Methods: During the period from April 2011 till March 2012, a total 25 laparoscopic nephrectomies of 25 patients with renal pathology such as non-functioning kidney and renal tumor underwent laparoscopic trans-peritoneal nephrectomy. Laparoscopic nephrectomy was performed by a specialized in laparoscopy surgeon for the first time at our institution. Data regarding individual characteristics, associated comorbidities, duration of operation, hospitalization, intraoperative and postoperative complications were recorded. The follow-up of the patients was one year after surgery. Results: A total 25 laparoscopic nephrectomies of 25 patients underwent laparoscopic nephrectomy, 16 (64%) male and 9 (36%) female patients. Average age of these patients was 43 years (range 7-59 years). The main indications for nephrectomy were non-functioning kidney in 15 cases (60%) and renal mass in 6 cases (24%) - 4 cases of renal cell carcinoma and 2 cases of oncocytoma were indicated. End-stage renal disease was diagnosed in 18 cases (72%). Eleven patients were hypertensive (44%) while five were diabetic (20%). The duration of operation ranged from 120 to 180 minutes (average 150 minutes). Average hospital stay was 4.5 days ranging between 3 and 5 days. Blood transfusion was performed in three patients (12%). Complications were encountered in 2 patient (8%), one suffered from retroperitoneal hematoma, another developed an incisional hernia. Conversion to open surgery was never deemed necessary in any of our cases. No oncological recurrence was noted during the follow-up period. Conclusions: Laparoscopic nephrectomy is a safe and minimally invasive procedure. Our initial experience is associated with promising results. The establishment of a fully equipped special unit with highly trained laparoscopic surgeons and personnel is important for a safe and effective performance of laparoscopic nephrectomy.