KUMJ | VOL. 19 | NO. 2 | ISSUE 74 | APRIL-JUNE 2021
Laparoscopic Surgeries in Urology: Initial Burgeoning Experience at National Transplant Centre, Nepal
Katwal BM, Koju S, Kunwar KJ, Shrestha D, Verma R, Shrestha PC
Abstract: Background
This study focuses on experience of laparoscopic surgery at Shahid Dharma Bhakta
National Transplant Centre (SDNTC), Nepal; which could enable us to gain knowledge
regarding its benefits over conventional surgery. The present study revealed the
frequency of various forms of laparoscopic surgeries done at our centre. Moreover,
this study accomplishes laparoscopic donor nephrectomy “a historical milestone
achieved in Nepal for kidney transplantation on 18
th
November 2018” which was the
first Laparoscopic donor nephrectomy done in Nepal by Nepalese team.
Objective
The present study assesses the feasibility and safety of laparoscopic surgery at
government hospital of Nepal.
Method
This hospital based cross-sectional study included all patients of age group 10 to 60
years, coming to outpatient department of SDNTC and those having indications for
nephrectomy. We excluded patient having previous history of open surgeries of kidney,
bleeding disorders, uncontrolled Diabetes Mellitus and uncontrolled Hypertension.
The study duration was 15 months from November 2017 to January 2019. The total
number of patients enrolled in the study was fifty where transperitoneal laparoscopic
surgery was performed in all 50 patients. The demographic data, indications for
surgery, duration of surgery, complications of surgery and perioperative outcomes
were analyzed.
Result
Out of 50 cases, 34 (68%) underwent simple lap nephrectomy, 6 (12%) were lap
pyeloplasty, 6 (12%) lap nephrectomy along with ureterectomy of long segment of
diseased ureter, 1 (2%) lap radical nephrectomy, 1 (2%) lap donor nephrectomy for
kidney transplantation, 1 (2%) lap heminephrectomy and 1 (2%) lap nephrectomy
for hydronephrotic non functioning left crossed ectopia. Amongst all nephrectomies,
27 (54%) patients were operated on right side while 23 (46%) patients on left. The
median age of the patient was 38.56 years. Out of total cases 32 (64%) were male
and 18 (36%) female. The median operative time and hospital stay was 122.3 minutes
and 5 days respectively. The median estimated blood loss was 74.1 cc. Only one
patient required blood transfusion intra-operatively. 2 (4%) patients were converted
to open surgery.
Conclusion
Laparoscopic surgery is feasible and safe procedure in government setup hospital
with less cumbersome procedure and minimum complications associated with it.
Keyword : First donor nephrectomy, Laparoscopic surgery, Nephrectomy, Transplantation
