Laparoscopic nephrectomy: an established routine procedure.
Between August 1992 and April 1993, 60 patients underwent laparoscopic nephrectomy in our institution for benign disease (35 hydronephrosis, 20 chronic pyelonephritis, 4 end-stage kidney, 1 renal hypoplasia). Conversion to open surgery was needed in six cases to overcome intraoperative bleeding or perirenal adhesions. The mean operative time was 3.5 +/- 1.3 hours, and the mean hospital stay was 3.2 +/- 2.1 days. No deaths occurred, but significant complications were encountered in four cases in the form of pulmonary embolism, a large hematoma, postoperative bleeding, and colonic perforation. Laparoscopic nephrectomy is a safe and effective alternative to open nephrectomy for benign renal conditions.