Retroperitoneal laparoscopic nephrectomy is safe and effective in obese patients: A comparative study of 55 procedures

Objectives, To compare the results of retroperitoneal laparoscopic nephrectomy (RLN) in obese and nonobese patients, because various open surgical procedures have been reported to result in higher morbidity in obese patients. Methods. Forty-eight consecutive patients underwent 55 RLNs in one center by one surgeon. Twenty-two patients were renal transplant recipients and underwent a total of 29 RLNs of the native kidney. Eight patients (9 procedures) were obese (body mass index 30 or more). The duration of the procedure, intraoperative and postoperative complications, and length of stay were compared between the obese and nonobese patients. Results. The median operative duration was 100 and 70 minutes in the obese and nonobese patients, respectively. Three intraoperative complications occurred in nonobese patients. One postoperative complication (12.5%) occurred in the obese patients; four(15.6%) occurred the nonobese patients. The median length of stay was 4 days for the obese and 3 days for the nonobese patients. The complication rate and postoperative length of stay were not significantly different between the two groups. Conclusions. RLN in obese patients was not associated with higher morbidity or longer hospitalization than in nonobese patients. We believe that RLN should be proposed to such patients when nephrectomy of a small nonfunctional kidney is indicated. UROLOGY 56: 63-66, 2000. (C) 2000, Elsevier Science Inc.