Concomitant laparoscopic renal surgery and cholecystectomy: outcomes and technical considerations.

INTRODUCTION

We report our experience with simultaneous laparoscopic treatment of coexisting kidney and gallbladder pathologies, assess the feasibility of this technique, and highlight some technical considerations.

METHODS

Our institutional database was searched for the records of simultaneous laparoscopic kidney surgery and laparoscopic cholecystectomy between 2002 and 2008. We retrieved data on patient demographics, preoperative work-up, surgical information, and postoperative outcome in terms of final pathology, complications, and hospital stay.

RESULTS

A total of 19 patients had undergone laparoscopic renal surgery combined with cholecystectomy. Renal surgery consisted of a laparoscopic partial nephrectomy in 5 patients (26.3%), a laparoscopic radical nephrectomy in 12 (63.2%), and a simple nephrectomy in 2 (10.5%). Laparoscopic cholecystectomy was performed as a second surgery in all 19 patients. Two patients simultaneously underwent a third procedure: one was a bilateral salpingo-oophorectomy, and the other was a postoperative ventral hernia repair with mesh. The average renal surgery time was 144 minutes, and the average cholecystectomy time was 28.0 minutes. All procedures were successfully completed laparoscopically with no conversions. The mean hospital stay was 4.2 days (median 4, range 2-8).

CONCLUSIONS

Combining laparoscopic renal surgery and laparoscopic cholecystectomy is a feasible, efficacious, and safe strategy that requires close collaboration between urologists and general surgeons. This approach offers the patient the benefits of minimally invasive surgery together with the obvious advantages of simultaneous treatment of coexisting pathologies.