1. STUDY OF LAPAROSCOPIC NEPHRECTOMY Presenting Author : Dr. SHRINIKETAN S. KALE (Resident) Co-Author : Dr. J.T. Sankpal MS FICS FIAGES FAIS Dr. S.V.Daga, Dr. S.N.Bamne, Dr. Shweta Shende Dept. of General and GI Lap. Surgery Dr. V.M.Govt. Medical College, Solapur.

2. Dr. V.M.Govt.Medical College, Solapur.

3. INTRODUCTION : Clayman et al in June 1990 did first trans peritoneal lap. nephrectomy for renal tumour same surgeon did first retroperitoneal lap. Nephrectomy Kavoussi et al first donor lap. nephrectomy Now has replaced open nephrectomy for many benign and malignant conditions with excellent results.

4. MATERIAL AND METHODS : 1). 20 cases of lap. Nephrectomy were. done. 2)
MATERIAL AND METHODS : 1) 20 cases of lap. Nephrectomy were done. 2) Male : 10 , Female : 10 3) Mean age was 40 years. 4) USG, IVP done in each patient to confirm non functioning of kidney. Patient having non functioning kidney subjected to renal scan. Patients with GFR < 10% were subjected to Lap. Nephrectomy.

5. PORT POSITION

7. RESULTS : 1). Mean age was 40 years (range 32-. 57 yrs. ). 2)
RESULTS : 1) Mean age was 40 years (range yrs.). 2) No patient in acute renal failure 3) Mean operative time 86 minutes. ( min.) 4) Oral intake started after 8 hrs. 5) Mean postoperative stay was 66 hrs. (48-92 hrs) 6) HPR : 16 patients having PUJ obstruction. 4 patients having chronic glomerulonephritis. 7) Complication two port site infection.

8. Comparison

9. DISCUSSION : Indications of lap. Nephrectomy 1)
DISCUSSION : Indications of lap. Nephrectomy 1) Chronic pyelonephritis 2) Obstructive or reflux uropathy. 3) Renal tuberculosis 4) Multicystic , dysplastic kidney. 5) Renovascular hypertension. 6) For donor nephrectomy 7) Nephrosclerosis 8) ADPKD 9) Post transplantation hypertension

10. DISCUSSION : Contra indications 1). Very large malignant tumours 2)
DISCUSSION : Contra indications 1) Very large malignant tumours 2) Coagulopathy or other contra indications to laparoscopy 3) Xanthogranulomatous pylonephritis - Approaches 1) Transperitoneal 2) Hand assisted transperitoneal 3) Retroperitoneal

11. DISCUSSION -. On left site lienorenal phrenicocolic. and
DISCUSSION - On left site lienorenal phrenicocolic and lienocolic ligaments has to be disected carefully. - Splenic injury is avoided - On right side kocherisation of duodenum has to be done. - While reflecting colon mesocolon should not be entered In case of renal malignancy kidney is removed without opening Gerota’s fascia.

12. CONCLUSION : 1). Less operative blood loss and. operative trauma 2)
CONCLUSION : 1) Less operative blood loss and operative trauma 2) Better postoperative recovery 3) Cosmetically better. 4) Effective in benign and malignant conditions. 5) Now a days better option for donor nephrectomy.

13. Thank You