Reninoma: case report and literature review.

Reninoma is a tumor of the renal juxtaglomerular cell apparatus that causes hypertension and hypokalemia via hypersecretion of renin. We describe a case of reninoma and provide a review of the literature, with a discussion emphasizing the diagnostic evaluation for such patients. The subject had persistent elevation of both plasma renin activity (PRA) and aldosterone.

Laparoscopic calicovesicostomy: a novel surgical procedure.

Laparoscopic calicovesicostomy in the horseshoe kidney with ureteropelvic junction obstruction associated with ipsilateral ureteral duplication and a large-capacity bladder is described. The intraoperative and postoperative clinical parameters were satisfactory in this preliminary report. Additional studies are necessary to evaluate this novel surgical procedure.

Ectopic adrenal tissue as radiographic lymphadenopathy in renal cell carcinoma.

In the presence of solid, contrast-enhancing renal mass, concomitant contrast-enhancing retroperitoneal mass is usually viewed as regional lymph node metastasis unless proven otherwise. The present report of ectopic adrenal tissue demonstrates that the presence of retroperitoneal contrast-enhancing mass may be a benign finding in patients with renal malignancy. Pathology remains the definitive method for diagnosis in such situation.

Laparoscopic Mitrofanoff appendicovesicostomy.

A novel technique of performing fully laparoscopic Mitrofanoff appendicovesicostomy in the management of neurogenic bladder is described. All steps, including appendix harvesting and extravesical appendiceal-vesical anastomosis with flap-valve mechanism creation, were completed laparoscopically and provided satisfactory preliminary clinical results. Additional studies are necessary for the evaluation of this novel technique.

A novel open surgical approach to transvesical distal ureterectomy in nephroureterectomy.

A single-incision transvesical approach to open distal ureterectomy is described herein. The surgical technique has been applied successfully to 6 consecutive patients undergoing laparoscopic nephrectomy with open distal ureterectomy for upper tract transitional cell carcinoma. The technique presented allows easy and effective excision of the ipsilateral distal ureter, ureteral orifice, and bladder cuff as well as closure of the single cystotomy.

Bipolar needle electrocautery for laparoscopic partial nephrectomy without renal vascular occlusion in a porcine model.

Objectives: To report a novel method of accomplishing laparoscopic lower pole partial nephrectomy in an acute porcine model using a bipolar needle electrode without the need for renal arterial occlusion.

Methods: Six animals (12 renal units) underwent laparoscopic polar nephrectomy using the bipolar needle electrode. After complete laparoscopic mobilization of the lower pole of the kidney, the bipolar needle electrode was repeatedly inserted full-thickness into the renal parenchyma and applied transversely, creating regional ischemia to the entire lower pole without renal vascular occlusion.

Anterior extraperitoneal approach to laparoscopic pyeloplasty in horseshoe kidney: a novel technique.

We describe a novel technique of laparoscopic pyeloplasty in the horseshoe kidney with ureteropelvic junction obstruction using an anterior extraperitoneal approach. The surgical technique is associated with satisfactory clinical outcomes. Additional studies are necessary to evaluate its potential as an alternative to the existing approaches to laparoscopic pyeloplasty.

Demographics of 353 laparoscopic renal donor and recipient pairs at the Johns Hopkins Medical Institutions.

Background And Purpose: The demographics of laparoscopic donor nephrectomy (LDN) have not been characterized in detail. The aim of this study was to review our LDN experience with respect to donor and recipient demographic characteristics and trends.

Patients And Methods: Over a 6-year period, 353 patients underwent LDN.

Effect of intentional cryo-injury to the renal collecting system.

Purpose: We determined the short-term and long-term sequelae of intentional cryoablation of the renal pelvicaliceal system and evaluated whether continuous irrigation of the renal pelvicaliceal system with warm saline protects it against cryo-injury.

Materials And Methods: In 12 swine open bilateral renal cryoablation using an argon gas based system was performed to create a cryolesion in the lower pole that was intentionally extended into the collecting system. A single cryoprobe was used to create a 3 cm ice ball in group 1 (6 animals) and 2, 3 mm cryoprobes were used to create a 4.

Laparoscopic radical nephrectomy incorporating intraoperative ultrasonography for renal cell carcinoma with renal vein tumor thrombus.

The purpose of this study was to describe the technique of laparoscopic right radical nephrectomy incorporating intraoperative, real-time ultrasonography in the management of renal cell carcinoma with level 1 renal vein tumor thrombus. With the patient in a modified flank position, a transperitoneal four-port approach was used to laparoscopically resect an 8.5-cm right renal mass with tumor thrombus extending to, but not into, the inferior vena cava.

Impact of renal artery multiplicity on outcomes of renal donors and recipients in laparoscopic donor nephrectomy.

Objectives: To review our laparoscopic donor nephrectomy experience to determine the impact of multiple renal arteries on renal donor and recipient outcomes. Multiple renal arteries can present a challenge during live laparoscopic donor nephrectomy.

Methods: During a 6-year period, 353 patients underwent laparoscopic donor nephrectomy and an equal number of patients underwent living-related renal transplantation.

Laparoscopic adult donor nephrectomy for pediatric renal transplantation.

To evaluate retrospectively our laparoscopic adult donor nephrectomy experience for pediatric transplantation. Since February 1995, 7 adult donors have undergone laparoscopic donor nephrectomy for pediatric renal transplantation (recipients younger than 18 years and weighing less than 30 kg). The outcomes of these donors and pediatric recipients were evaluated.

Renovascular complications of laparoscopic donor nephrectomy.

Objectives: To review the operative renovascular injuries related to our laparoscopic donor nephrectomy experience, since management of intraoperative renovascular complications during laparoscopic nephrectomy can present a serious challenge.

Methods: During a 6-year period, 353 patients underwent laparoscopic donor nephrectomy. A retrospective chart review was performed to identify and evaluate the renovascular complications associated with the procedure.

Laparoscopic donor nephrectomy in the elderly patient.

Objectives: To evaluate retrospectively the outcome of laparoscopic donor nephrectomy in patients aged 65 years or older, because data regarding tolerance profile and renal allograft outcome of laparoscopic donor nephrectomy in the elderly patient are lacking.

Methods: Since February 1995, 6 patients aged 65 years or older underwent laparoscopic donor nephrectomy for living-related renal transplantation. Patient demographic, intraoperative, and postoperative parameters, as well as renal allograft outcome, were evaluated.

Laparoscopic ileovesicostomy.

Purpose: We present our initial experience with laparoscopic ileovesicostomy for managing neurogenic bladder.

Materials And Methods: A 5 port transperitoneal approach was used for laparoscopic ileovesicostomy. After bladder preparation a 17 cm.

Novel technique for combined repair of postirradiation vesicovaginal fistula and augmentation ileocystoplasty.

Concomitant vesicovaginal fistula and significant bladder contracture after radiation is an uncommon but complex urologic problem. We describe a surgical technique to address both issues and present our preliminary clinical data.

Bilateral laparoscopic adrenalectomy: retroperitoneal and transperitoneal approaches.

Objectives: To report our experience with bilateral laparoscopic adrenalectomy using either the retroperitoneal or the transperitoneal approach.

Methods: Between June 1998 and October 2000, 6 consecutive patients with bilateral adrenal disease (Cushing syndrome in 4, pheochromocytoma in 1, and solitary adrenal metastases in 1) underwent bilateral laparoscopic adrenalectomy by way of the retroperitoneal or transperitoneal approach. Bilateral adrenalectomy was performed either synchronously (4 patients) or in a staged manner (2 patients).

Nephron-sparing nephrectomy for giant renal angiomyolipoma associated with lymphangioleiomyomatosis.

Renal angiomyolipomas are benign tumors known to occur sporadically and in association with genetic syndromes, including tuberous sclerosis and lymphangioleiomyomatosis. Surgical removal or radiographic embolization of angiomyolipomas larger than 4 cm is usually indicated because of an increased risk of spontaneous hemorrhage. We describe successful nephron-sparing surgery for a giant angiomyolipoma and discuss relevant management issues in a patient with lymphangioleiomyomatosis who had previously undergone bilateral pulmonary transplantation.

The effect of dopamine on renal function in solitary partial nephrectomy surgery.

Purpose: Dopamine continues to be used for preventing and treating acute renal failure. We determined the effects of dopamine on postoperative renal function in patients with a solitary kidney undergoing partial nephrectomy.

Materials And Methods: We performed a prospective randomized controlled study at a tertiary care referral center involving 24 patients with a solitary kidney undergoing partial nephrectomy secondary to malignancy.