Laparoscopic partial nephrectomy and pyeloplasty at one stage – a case from practice and literature review

Bulgarian Medical Journal, 2025, 19(1), 61-65.

S. Stanimirov

Clinic of Urology, University Hospital “Deva Mariа” – Burgas

Abstract. Introduction: Laparoscopic partial nephrectomy for a tumor formation, or also called laparoscopic partial resection of the kidney (LPRK), is increasingly performed for selected small kidney formations. However, LPRK is a technically challenging procedure. The need to clamp the hilus arterial vessels remains a major challenge for this operational technique. Plastics of the renal pelvis – pyeloplasty, is a method of surgical treatment of hydronephrosis caused by congenital stenosis of the pyeloureteral junction. In this condition, an additional blood vessel, which exerts external compression on the ureter, is often found in the same area. Today, laparoscopic pyeloplasty is the method of choice for the treatment of congenital hydronephrosis. The aim of the paper is to present a case from the practice of laparoscopic partial resection of a tumor formation of the right kidney with pyeloplasty of the same kidney at one stage and review the literature. Clinical Case Description: A 62-year-old patient, with hydronephrosis of the right kidney and a nephrostomy placed in other medical facility, was admitted. For this complaints, the patient sought consultation with a urologist for surgical treatment and removal of the nephrostomy. The subsequent CAT of abdominal organs and pelvis found hydronephrosis of the right kidney with stenosis of the pyeloureteral segment and a tumor formation of a diameter of 40 mm, located in the region of the upper pole, on the dorsal surface of the kidney. After a clinical discussion, it was decided to perform a one-stage laparoscopic surgery for removal of the tumor formation and plasty of the pyeloureteral segment. The patient was informed and signed informed consent form for the proposed surgery. At one stage, in one operating period, a transperitoneal laparoscopic Y-V plasty of the pyeloureteral segment was performed, followed by partial resection of the tumor formation without clamping of the hilus vessels. Operational time was 210 min. Blood loss was 150 ml. No complications were observed in the early and late operative periods. The patient was discharged on day 5. Conclusion: Laparoscopic surgical technique can be used in selected cases of combined diagnoses of a single kidney. The method enables oncological treatment and plastics technique at one stage. More cases are needed to determine the role of the method in daily practice.

Key words: rabies, DFAT, TaqMan® RT-PCR, Bulgaria

Address for correspondence: Stanimir Stanimirov, Department of Urology, University Hospital Deva Mariа, Aleksandar Stamboliiski Str., Vetren, Burgas, GSM: +359896303348, е-mail: , Original report: https://orcid.org/0009-0006-9555-8243