ABSTRACT
Retroperitoneal endoscopic nephrectomy with the patient in the prone position was performed in 12 patients. Indications for this procedure were end-stage kidneys with ureteropelvic junction stenosis or distal ureteric obstruction, nonfunctional kidneys with drug resistant renin-mediated hypertension, and distal ureter malignancy. The retroperitoneal area was exposed using an open surgical technique in combination with the use of a liquid-filled dissection balloon. Removal of kidney tissue was performed with a morcellator through one of the ports. On average, the operating time was 210 min (range 160-480 min) to complete a one-sided nephrectomy. No major complications occurred. Mean hospital stay in this series was 6.6 days, and the follow-up period was uncomplicated in all cases. Retroperitoneal endoscopic nephrectomy with the patient in the prone position is an acceptable alternative to open nephrectomy in selected indications.