Laparoscopic Decortication of Simple Renal Cyst with Omental Wadding Technique: Single-Center Experience

Abstract

What is the impact of the omental wadding technique on decreasing the incidence of recurrence after laparoscopic decortication of the symptomatic simple renal cyst? This is the question we are trying to answer through this study. This is a cohort study of 14 consecutive patients who underwent transperitoneal laparoscopic decortication of a symptomatic simple renal cyst with the omental wadding technique between November 2007 and November 2011. The indication for surgery was for relief of pain in all cases. Pain was assessed preoperatively and at 1 month and every 6 months postoperatively using a pain numerical rating scale. Only simple cysts (Bosniak I and II) more than 10 cm in their greatest dimension were included in this study. Patients with complicated cysts (Bosniak III and IV) and those with cysts less than 10 cm in their greatest dimension were excluded from this study. Patients were 7 men and 7 women with a mean age of 47 years (range, 35-63 years), and the mean body mass index was 27 kg/m(2). Laparoscopic decortication was the primary treatment in 11 cases and the secondary treatment in 3 cases after sclerotherapy. We used the omental wadding technique to try to fill the cavity after decortication to decrease the incidence of recurrence with simple laparoscopic decortication reported in other series. We reviewed the preoperative and postoperative data. The operation was successfully completed laparoscopically in all cases with a mean operative time of 97 minutes without major perioperative complications. Hospital stay was 2.4 days (range, 2-4 days). All cases improved significantly after operation in a mean follow-up of 1.5 years. Using this technique, we did not have any recurrence after surgery. Laparoscopic decortication with omental wadding is helpful to decrease the incidence of simple renal cyst recurrence after laparoscopic decortication.