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International braz j urol

Print version ISSN 1677-5538On-line version ISSN 1677-6119

Int. braz j urol. vol.44 no.5 Rio de Janeiro Sept./Oct. 2018

http://dx.doi.org/10.1590/s1677-5538.ibju.2017.0390 

Video Section

Robot-Assisted Nephropexy

Marcelo Langer Wroclawski1  2 

Guilherme Andrade Peixoto2 

Marcio Covas Moschovas2 

Arie Carneiro1 

Milton Borrelli Jr.1 

José Roberto Colombo Jr.1 

1Hospital Israelita Albert Einstein, São Paulo, SP, Brasil

2Departamento de Urologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil

ABSTRACT

Introduction:

Renal ptosis is defined as the renal descent when there is a change from supine to orthostatic position, usually with a change of two vertebral bodies or more than five cm apart. Although rare, it is one of the causes of chronic flank pain or of upper abdomen. The typical patient of renal ptosis is young, female, thin, with complaint of pain when in an upright position (1, 2).

Objective:

Demonstrate a robot-assisted nephropexy technique in a young woman diagnosed with symptomatic renal ptosis on the right kidney, confirmed by imaging tests.

Materials and Methods:

A 29-year-old female patient with a history of chronic right-sided pain and palpable renal mobility on physical examination. The diagnosis of renal ptosis was confirmed by ultrasound imaging, excretory urography (Figure-1), and renal scintigraphy with 99mTc-DTPA (Figure-2). She was submitted to a robotic-assisted right nephropexy with a polypropylene mesh fixing the right kidney to the ipsilateral psoas muscle fascia.

Result:

We reported a 96-minute surgical time. The patient was discharged in the first postoperative day. At the one-month follow-up, there was an important improvement of the symptoms, with normality renal function and imaging tests describing adequate renal positioning.

Conclusions:

Robotic-assisted nephropexy is feasible and can be an excellent minimally invasive alternative technique for the proposed surgery. We reported a shorter hospital stay and a faster postoperative recovery compared with the opened procedure.

Figure 1 Excretory urography. 

Figure 2 Renal scintigraphy. 

ARTICLE INFO

Available at: http://www.intbrazjurol.com.br/video-section/20170390_wroclawski_et_al

Int Braz J Urol. 2018; 44 (Video #14): 1047-1048

Published as Ahead of Print: November 21, 2017

REFERENCES

1. Kavoussi LR, Schwartz MJ, Gill IS. Laparoscopic Surgery of the Kidney. Campbell-Walsh. 10th Edition. 2011; 1645-7. [ Links ]

2. Arnerlöv C, Söderström M, Öhberg L. Mobile kidney pain provocation ultrasonography before surgery for symptomatic mobile kidney: A prospective study of 43 consecutive patients. Scand J Urol. 2016;50:61-4. [ Links ]

Received: June 29, 2017; Accepted: September 20, 2017

Correspondence address: Guilherme Andrade Peixoto, MD, Departamento de Urologia, Faculdade de Medicina do ABC, Rua Johana Luise Falkenburg Binder, 98, São Bernardo do Campo, SP, 09732-290, Brasil, E-mail: gui_peixoto@uol.com.br

CONFLICT OF INTEREST

None declared.

Creative Commons License This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.