Laparoscopic subcapsular nephrectomy.

A 26-year-old patient with end-stage renal disease secondary to vesicoureteral reflux and recurrent pyelonephritis was referred for bilateral native nephrectomy. A transperitoneal laparoscopic approach was used. Extremely dense fibrosis was encountered around the left kidney during the dissection. A left laparoscopic subcapsular nephrectomy and a right extracapsular nephrectomy were performed. The indications and surgical technique for laparoscopic subcapsular nephrectomy are discussed.