A Review of the First 100 Cases of Laparoscopic Nephrectomy: A Single-Center Experience

Objective Since 1990, when the first laparoscopic nephrectomy was performed, there has been a dramatic increase in interest in laparoscopic procedures in urological surgeries. The aim of the study was to present our experience with the first 100 cases of laparoscopic nephrectomy at our institute, identify the difficulties encountered, and discuss how to approach the solutions. Materials and methods The data of all patients who underwent laparoscopic nephrectomy between May 2017 and April 2019 (n=100) were reviewed retrospectively. Results A total of 100 patients (49 men and 51 women), with a mean age of 34.1 +/- 15.1 years, underwent laparoscopic nephrectomy. The mean operative time was 108 min (IQR, 45-240). The operative time was significantly reduced with the surgeons' experience. Of 100 cases, only four were converted to open surgery because of bleeding from the renal bed area, strong adhesions from previous surgeries, or morbid obesity. Of 100 patients, 30 were allowed intake on the same operative day while 70 were allowed on the first postoperative day. Intravenous and oral analgesics were discontinued on the second postoperative day in 81 patients. Conclusion The learning curve in our series of cases is comparable to a very similar study with reduced operative time, reduced blood loss, and fewer complications when compared to open nephrectomy. In addition, setups with minimal previous laparoscopic units can initiate laparoscopic procedures with minimal risk to the patient.