Laparoscopic Renal Biopsy via Retroperitoneal Approach

Gaur, D.D.; Agarwal, Dinesh; Khochikar, Makarand; Purohit, K.C.

doi:10.1016/s0022-5347(17)35123-6

Cited by 28 publications

(9 citation statements)

References 7 publications

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“…A laparoscopic (through a retro-or transperitoneal approach) or open kidney biopsy may be the best option in selected circumstances, such as morbid obesity, solitary kidney, coagulopathy, failed PRB, polycystic kidney disease with rapidly progressive GN, high location of the kidney, and/or poor visualization with imaging (26)(27)(28)(29). These approaches have the theoretical advantage of direct visualization and application of hemostatic materials (such as absorbable gelatin and oxidized cellulose) to the biopsy sites, but no studies have been performed to show improved complication rates.…”

Section: Other Biopsy Techniquesmentioning

confidence: 99%

The Native Kidney Biopsy

Hogan

Mocanu

Berns

2016

Clinical Journal of the American Society of Nephrology

236

228

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The kidney biopsy is the gold standard in the diagnosis and management of many diseases. Since its introduction in the 1950s, advancements have been made in biopsy technique to improve diagnostic yield while minimizing complications. Here, we review kidney biopsy indications, techniques, and complications in the modern era. We also discuss patient populations in whom special consideration must be given when considering a kidney biopsy and the important role that the kidney biopsy plays in nephrology training. These data are presented to develop best practice strategies for this essential procedure.

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Section: Other Biopsy Techniquesmentioning

confidence: 99%

The Native Kidney Biopsy

Hogan

Mocanu

Berns

2016

Clinical Journal of the American Society of Nephrology

236

228

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“…Renal biopsy was reinforced after the report by Iversen & Braun showing PNRB as a safe, easy and less morbid method (15 Although PNRB is the standard procedure to obtain renal tissue samples nowadays, it is not indicated in different situations such as noncollaborative patients, failure to obtain samples for pathology tests, solitary kidney, morbid obesity and hematological disorders (1-4). In these cases, some authors suggest laparoscopic approach as an alternative to ORB (7)(8)(9)(10)(11)(12)16).…”

Section: Commentsmentioning

confidence: 99%

“…As an alternative to ORB in selected cases, some authors propose transperitoneal (7) or retroperitoneal laparoscopic approach (8)(9)(10)(11)(12). Laparoscopy allows potential advantages such as less postoperative pain, better cosmetic results, short hospitalization and convalescence (13,14).…”

Section: Introductionmentioning

confidence: 99%

Retroperitoneoscopic renal biopsy in children

et al. 2007

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Objective: We present our experience in a series of 17 consecutive pediatric patients submitted to retroperitoneal laparoscopic renal biopsy. Materials and Methods: Retroperitoneal laparoscopic renal biopsy (LRB) was performed in 5 boys and 12 girls. Mean age was 8.1 years and age range from 2 to 12. Two or three trocars were used to expose the inferior pole of the kidney, remove enough cortical parenchymal specimen and fulgurate the biopsy site. Assessment included surgical time, estimated blood loss, hospitalization period, analgesia requirements, complications and number of glomeruli present in the specimen. Results: LRB was successfully performed in all 15 patients (88%). In two cases, LRB was not possible to be performed. One patient was converted to a transperitoneal laparoscopy due to tear in the peritoneum. The other patient had had previous abdominal surgery and, during retroperitoneal balloon dilation, the peritoneum was opened and the open biopsy was performed. A third patient had postoperatively a perirenal hematoma, which was solved spontaneously. Complication rate was 17.6% (3/17 cases). Mean operative time was 65 minutes, while mean estimated blood loss was 52 mL, mean hospital stay was 2.2 days and mean analgesic requirement was 100 mg of tramadol. The mean number of glomeruli present in the specimen was 60. Conclusion: Retroperitoneal laparoscopic renal biopsy in children is a simple, safe. Bleeding is still the most common complication. However, direct vision usually allows a safe control of this drawback. In our institution, laparoscopic approach is the chosen procedure in pediatric patients older than one -year -old.

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“…In these patients other options for biopsy, e.g. open renal [2,3], laparoscopic renal [4][5][6][7], endovascular [8][9][10], CT-guided and ureteroscopic [11] could be used; each has specific advantages and limitations.…”

Section: Authors From Varanasi India Describe How Artificial Neural mentioning

confidence: 99%

Laparoscopic renal biopsy: a 9‐year experience

Shetye¹,

Kavoussi²,

Ramakumar³

et al. 2003

BJU International

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Renal biopsy is a frequent procedure in patients with suspected intrinsic renal disease. In some patients the blind percutaneous approach is contraindicated; the authors from Johns Hopkins describe their experience over a 9‐year period using a laparoscopic approach. They found that adequate tissue could be obtained for biopsy in the large majority of cases, and that complications occurred in a tiny minority. Most patients were discharged within 24 h. They indicate the advantages in removing tissue by this method. Authors from Varanasi, India describe how artificial neural networks were used in an attempt to predict optimum renal stone fragmentation in patients undergoing ESWL. They were encouraged by the findings in what was essentially a pilot study, and felt that with a larger data set, the value of their network system could be enhanced. OBJECTIVES To present our experience and outcome of consecutive laparoscopic renal biopsy over a 9‐year period, as renal biopsy remains an important diagnostic procedure for evaluating proteinuria, haematuria and renal failure, but when percutaneous biopsy is contraindicated, a laparoscopic biopsy is an attractive option because it is minimally invasive. PATIENTS AND METHODS Seventy‐four patients (29 male, 45 female, mean age 45 years, range 3–79) had a laparoscopic renal biopsy taken for various indications, e.g. morbid obesity, solitary kidney, coagulopathy, failed percutaneous biopsy, high location of the kidney and poor visualization with ultrasonography. The kidney was approached via a laparoscopic retroperitoneal route using a two‐port technique, with the patient in the flank position. After identifying the kidney, one to five cortical biopsies were obtained with cup‐biopsy forceps. RESULTS Adequate tissue was obtained in 96% of the patients; the mean (range) operative duration was 123 (9–261) min and the estimated blood loss 67 (5–2000) mL. Forty‐three patients were discharged within 24 h. Complications occurred in 10 patients, with significant bleeding in three. One patient died after surgery, secondary to a perforated peptic ulcer while on high‐dose steroid therapy. CONCLUSION Laparoscopic renal biopsy is a safe and effective alternative to open renal biopsy for patients in whom percutaneous biopsy is not feasible. It offers the advantage of obtaining cortical biopsies and achieving haemostasis under direct vision. Adequate renal tissue is obtained in most cases. Recovery and convalescence are short for most patients.

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Laparoscopic Renal Biopsy via Retroperitoneal Approach

Cited by 28 publications

References 7 publications

The Native Kidney Biopsy

The Native Kidney Biopsy

Retroperitoneoscopic renal biopsy in children

Laparoscopic renal biopsy: a 9‐year experience

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