Renal cell carcinoma (RCC) during pregnancy is rare and presents a unique clinical dilemma, requiring the simultaneous optimisation of maternal oncological outcomes and fetal safety. Management decisions must balance the urgency of treating a potentially aggressive malignancy against the physiological and obstetric risks of intervention. We present the case of a large, incidentally detected clear cell RCC in a pregnant patient, managed successfully with laparoscopic radical nephrectomy during the second trimester. This case underscores the importance of multidisciplinary collaboration and tailored surgical planning in achieving favourable outcomes for both the mother and fetus.

This study compared the analgesic effects of the anterior quadratus lumborum block at the lateral supra-arcuate ligament (QLB-LSAL) and thoracic paravertebral block (TPVB) for laparoscopic nephrectomy to verify whether the new quadratus lumborum block is an efficient technique for managing laparoscopic nephrectomy pain as an alternative to TPVB. This study was a prospective randomized noninferiority clinical trial. Before general anaesthesia, 80 participating patients were randomly allocated to receive QLB-LSAL (20 mL of 0.5% ropivacaine) or TPVB (20 mL of 0.5% ropivacaine). The primary outcome was the mean visual analogue scale (VAS) score in the first 24-hafter surgery. The secondary outcomes included the cutaneous sensory block area, intraoperative haemodynamic changes, consumption of sufentanil at 24-hpostoperatively, and postoperative recovery data. The mean VAS score during the first 24-hwas 1.92 ± 0.28 in the QLB-LSAL group and 1.79 ± 0.25 in the TPVB group. The mean treatment difference (QLB-LSAL-TPVB) in the primary outcome was 0.13 (95% CI 0.02 to 0.25). The upper limit of the 95% CI remained below the non-inferiority margin. After 10 and 30 min, the TPVB group had significantly greater cutaneous sensory block area (p < 0.001). The consumption of sufentanil at 24-h postoperativelywas similar between the two groups (p > 0.05). Neither intraoperative hemodynamic alterations nor postoperative recovery metrics showed significant differences between the two groups (p > 0.05). At 24-h postoperatively,QLB-LSAL had analgesic effects that were not inferior to those of TPVB for patients undergoing laparoscopic nephrectomy. Chinese Clinical Trial Registry website; registration number: ChiCTR2100048226.

The gold standard treatment for renal cell carcinoma with a tumor thrombus (RCC-TT) is radical nephrectomy with tumor thrombectomy (RN-TT). Operative approaches to this can be done open (ORN-TT), laparoscopic (LRN-TT), or robotic (RRN-TT). The purpose of this study was to compare overall survival (OS), cancer-specific survival (CSS), and metastasis-free survival (MFS) between open, laparoscopic, and robotic approaches to RN-TT using the Intercontinental Collaboration on Renal Cell Carcinoma (ICORCC) database. Patient records were reviewed from the ICORCC database. All patients included in the study underwent RN-TT for RCC-TT from 1999 to present. Tumor thrombus level was graded using the Neves classification system. Statistical analysis was carried out using analysis of variance, chi-squared test, and Kaplan–Meier survival curves with log-rank test to compare outcomes by surgical approach. A total of 392 patients were included. There were 308 ORN-TT, 61 LRN-TT, and 23 RRN-TT cases. On Kaplan–Meier analysis, OS and CSS were not significantly different by approach (p > 0.05). MFS was significantly lower in RRN-TT patients (p = 0.030). Operative time was the longest in ORN-TT, followed by LRN-TT, and RRN-TT the quickest (p = 0.011). Blood transfusion rates were significantly lower in RRN-TT relative to ORN-TT (p < 0.001). Rates of lymph node dissection, soft tissue margin positivity, and cytoreductive surgery were alike (p > 0.05). There is no definitive superiority of one operative approach compared to another. RRN-TT may result in worse MFS for patients, which calls for further investigation, but this is not certain. Ultimately, the risks, benefits, and resources the surgeon has at his/her disposal should all play in the final operative choice of RN-TT for the patient.

Comparative analysis of Robotic-Assisted, Laparoscopic, and open radical nephrectomy: Utilization, Costs, and clinical outcomes

Understanding Decision Making and Post-Donation Experiences for Robotic Single Port and Laparoscopic Donor Nephrectomy.

Incidence and Impact of Elevated Creatine Kinase Following Living Donor Nephrectomy.

Robot-assisted laparoscopic radical nephrectomy for renal cell carcinoma with direct colon invasion and concomitant inferior vena cava tumor thrombus: A case report

ABSTRACTSolitary fibrous tumors (SFTs) are rare spindle cell tumors that primarily originate from the pleura, with infrequent occurrences in the kidney. To date, only a limited number of cases has been reported. This report presents the case of a 52‐year‐old woman diagnosed with an SFTs. Abdominal CT and magnetic resonance imaging revealed a mass lesion in the right kidney, characterized by well‐defined borders and the absence of necrosis or cystic degeneration. Immunohistochemical staining of the tumor tissue demonstrated positive expression of CD34, STAT‐6, and CD99, thereby confirming the diagnosis of SFTs in the right kidney. A laparoscopic radical nephrectomy was performed. A comprehensive literature review was conducted to systematically assess the current understanding of renal SFT. The diagnosis of renal SFTs is established through the synthesis of clinical, pathological, immunohistochemical, and molecular characteristics. Surgery is the treatment of choice. In cases of advanced disease, this is considered the optimal therapeutic approach.

The effect of hyperoxia on disordered breathing during recovery from general anesthesia: A single-blinded, crossover, non-randomized -controlled, trial.

BackgroundThe analgesic efficacy of transmuscular quadratus lumborum block (TQLB) as a means of decreasing the need for opioid use following laparoscopic nephrectomy has been demonstrated in several studies, but the effect of the lower thoracic paravertebral block via posterior pathway of medial arcuate ligament under direct visualization (LTPB-MAL) in this surgical context remains to be clearly elucidated.ObjectivesTo juxtapose the pain-relieving potency of the TQLB and the LTPB-MAL in individuals receiving laparoscopic nephrectomy.DesignA randomized controlled study.SettingUniversity-affiliated tertiary care hospital.MethodsOne hundred and two individuals slated for laparoscopic nephrectomy under general anesthesia were assigned to acquire either TQLB or LTPB-MAL by chance, with both groups receiving 25 ml of 0.5% ropivacaine post-surgery. The primary outcome was the total intravenous morphine equivalent doses consumed within the first day post-operatively. Secondary outcomes included pain intensity; interval to first opioids request; rescue analgesics use; and occurrence of nausea/vomiting; time to first ambulation; hospital duration and satisfaction scores.ResultsThe patients receiving LTPB-MAL consumed significantly less intravenous morphine equivalent doses than those receiving TQLB in the first 24 h after surgery, with a mean (SD) of 23.5 (7.6) mg versus 33.6 (10.2) mg, P < 0.001, respectively. Time to the first opioid request in the LTPB-MAL group was significantly prolonged compared with the TQLB group, P < 0.001. No considerable discrepancy was observed in pain intensity, rescue pain consumption, satisfaction scores, incidence of nausea or vomiting, or ambulation and length of hospital stay within the two groups.ConclusionLTPB-MAL significantly reduces postoperative opioids usage in the first 24 h after surgery and delays the initial opioid request, endorsing it as an enhanced strategy for multimodal analgesia in laparoscopic nephrectomy.Trial registrationThe Ethics Committee of Beijing Chaoyang Hospital granted ethical approval for our study protocol on May 10, 2022 (2022-ke-447). The study was officially registered with the Chinese Clinical Trial Registry (ChiCTR2200060507) on June 3, 2022.Supplementary InformationThe online version contains supplementary material available at 10.1186/s12871-025-03417-z.

Abstract. Objective. To evaluate the efficacy and safety an original transmesenteric approach for laparoscopic nephrectomy with thrombectomy in patients with left kidney cancer and venous tumor thrombus (levels 0–I according to the Mayo classification). Materials and methods. The study included 19 patients with histologically verified left kidney cancer who underwent laparoscopic nephrectomy with thrombectomy using a transmesenteric approach. Eleven patients had renal vein thrombus (Mayo level 0), and eight patients had thrombus extending into the inferior vena cava up to 2 cm from the renal vein orifice (Mayo level I). The following parameters were assessed: age, body mass index, operative time, intraoperative blood loss, hospital stay, and postoperative complications. Results. All procedures were completed laparoscopically without conversion. The mean operative time was 125.8 ± 11.4 min, and the mean blood loss was 152.6 ± 62.9 ml. The mean hospital stay was 7.4 ± 0.6 days. No early or late complications were recorded. Operative time and blood loss were significantly lower compared to previously published series of laparoscopic and open procedures. Conclusion. The transmesenteric approach minimizes surgical trauma, reduces operative time and blood loss, and lowers the risk of complications while maintaining oncological radicality. The method can be recommended for widespread use in onco-urological practice. Keywords: renal cell carcinoma; venous tumor thrombus; laparoscopic nephrectomy; thrombectomy; transmesenteric approach

Ultrasound-Guided Erector Spinae Plane Block for Perioperative Analgesia in Patients Undergoing Laparoscopic Nephrectomies: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

IntroductionTuberous sclerosis complex (TSC) is an autosomal dominant disease affecting multiple organs and systems throughout the body. The rupture and bleeding of TSC-associated renal angiomyolipoma (RAML) are the most common causes of death in adults with TSC. Clinically, interventional embolization and open surgery remain the standard treatment options for RAML, with laparoscopic procedures being comparatively less utilized.MethodsThis article details the management of a 59-year-old male with TSC who presented with spontaneous rupture and hemorrhage of a large right renal RAML exceeding 15 cm in diameter. A laparoscopic right nephrectomy was successfully performed as the definitive treatment.ResultsThe laparoscopic procedure was successful in managing the acute hemorrhage and removing the affected kidney. The patient's postoperative course was uncomplicated.DiscussionThe diagnostic and therapeutic management of this complex case is discussed, along with a review of the relevant literature. This case demonstrates that laparoscopic nephrectomy can be a viable surgical option for the emergency treatment of giant TSC-associated RAML rupture and bleeding in selected patients.

Laparoscopic urology has marked a significant advancement in paediatric surgery, offering less invasive procedures and improved postoperative outcomes. Initially utilised for diagnosing cryptorchidism in 1976, its therapeutic applications expanded in the 1990s to include surgeries such as orchiopexy, nephrectomy, pyeloplasty, etc. Laparoscopy, as a minimally invasive technique, allows visualization and treatment of abdominal and pelvic organs. The therapeutic potential of laparoscopy emerged in the 1990s, when Clayman and colleagues performed the first laparoscopic nephrectomy, marking the start of therapeutic laparoscopy. Since then, it has evolved significantly, becoming a standard approach in many pediatric urology centers. Technological advancements, particularly the development of miniature equipment and robotic-assisted surgery, have transformed paediatric laparoscopy, making it feasible even for neonates and infants. However, challenges persist, including increased expenses, a steep learning curve, and the need for compelling evidence before newer technologies are widely implemented. Future directions include improving telemedicine support, investigating paediatric-specific procedures, and integrating novelties such as single-site laparoscopy and natural orifice transluminal endoscopic surgery. While laparoscopic techniques have significantly advanced, further research is required to assess long-term results, cost-effectiveness, and the psychological impact on children. This narrative review highlights the revolutionary impact of laparoscopy on paediatric urology, emphasising the need for ongoing research, training, and global collaboration to optimise outcomes and ensure wider accessibility. By addressing these challenges and refining new technologies, the future of laparoscopy in paediatric urology appears promising, with the potential to significantly improve the lives of young patients with urological conditions.

A single-port radical nephrectomy, in comparison to laparoscopic multiport and robot-assisted laparoscopic procedures, provides advantages such as a shorter recovery period, reduced postoperative pain, diminished blood loss, and satisfactory cosmetic results, despite a marginally extended operation duration. This paper presents a case involving renal cell carcinoma (RCC) in a native kidney of a patient who had undergone an ipsilateral kidney transplant. It illustrates an alternative treatment with a favorable safety profile and oncological outcomes. The patient chose to undergo this complex surgical procedure, thereby highlighting its feasibility and potential benefits in managing complex urological conditions.

Open nephrectomy surgery in a kidney donor involves pain and many risks after the surgery, which leads to the inability to perform normal activities. For this reason, today the laparoscopic nephrectomy method is preferred in order to avoid complications and to return to normal life sooner. However, it is very critical to assess the impact of modifying the surgical technique on the outcome of kidney donation. Thus, the present study was undertaken with the following specific objective: a comparative study of the renal profile of live kidney donors who have undergone open and laparoscopic nephrectomy. The study in the present report was cross-sectional in nature. Participants included 91 kidney donors who had undergone either open nephrectomy (n = 46) or laparoscopic nephrectomy (n = 45). Data on the level of initial basic renal function, the duration of surgery, and the duration of hospitalization, together with the course of renal function in the 6 months after surgery, were collected. The data were analyzed using the Statistical Package for the Social Sciences, version 27 (SPSS version 27). The mean age of kidney donors was 29.4 ± 4.8 years, and all patients were male (100%). Body mass index and weight were comparable between the open and laparoscopic nephrectomy groups, with no statistically significant differences (P> 0.05). The mean duration of surgery in the open nephrectomy group (2.37 ± 0.30 hours) was significantly shorter than that in the laparoscopic group (3.37 ± 0.13 hours) (P< 0.001). The mean length of hospital stay was significantly shorter in the laparoscopic group (3.31 ± 0.31 days) compared to the open group (4.06 ± 0.04 days) (P< 0.001). GFR decreased significantly in both groups at discharge and 6 months postoperatively compared to baseline (paired t-test, allP< 0.001), but there was no significant difference in GFR between groups at any time point (P> 0.05). Both groups experienced a significant postoperative decline in hemoglobin, with a greater reduction in the open group (-1.59 ± 0.79 g/dL) compared to the laparoscopic group (-1.05 ± 0.95 g/dL) (P= 0.004). White blood cell counts increased postoperatively in both groups, with no significant difference between them (P= 0.118). Surgical complications included transection of the superior polar artery in 5.5% of cases. In laparoscopic nephrectomy, the time of surgery is longer, but the days of hospitalization after surgery do not differ and do not negatively affect the return of donor kidney function compared to the open method. Moreover, post-surgical problems have not been very frequent and are manageable in the best way possible.

Kidney transplantation is the best treatment option for patients with end-stage renal disease, with better survival rates. Laparoscopic donor nephrectomy, which is a surgical advancement from the open donor nephrectomy, was first performed in 1995 and was found to have a better cosmetic outcome, shorter hospitalization, with similar quality of allograft when compared to those harvested by open donor nephrectomy. We commenced laparoscopic donor nephrectomy in 2022 at Zenith Medical and Kidney Center, Abuja, Nigeria, and hereby present the case series of the three patients operated on so far. Laparoscopic donor nephrectomy is a welcomed surgical procedure with improved patient satisfaction after surgery and better cosmetic outcomes. Renal function after recipient surgery is also satisfactory.

Retrospective Evaluation of the Effect of Laparoscopic and Conventional Donor Nephrectomy on Graft Functions.

Objective: Laparoscopic nephrectomy is preferred surgery to treat patient with renal mass and Nonfunctioning kidney (NFK) secondary to urolithiasis/ PUJO/ureteric stricture. Main objective of this study was to assess risk associated with conversion of laparoscopic nephrectomy in patient undergoing laparoscopic nephrectomy in our university hospital. Material and Methods: This was retrospective descriptive observational study which included 78 patients diagnosed with NFK by CT IVU and diuretic DTPA renogram, renal mass by CT IVU presented to Dhulikhel hospital from 1st January 2023 to 15th May 2025. Patients were reviewed in terms of demographic characteristics and clinical presentation. Statistically correlated with conversion and laparoscopic group which was analyzed by using student’s t-test and fischer exact test. Results: Mean age was 48.69 ± 14.18 years, 42 female (53.85%) and 36(46.15%) male patients. Mean operative duration was 238.5±68.68 minutes in conversion whereas in laparoscopic group was 177.06±43.99 minutes, p&lt;0.05. Mean hospital stay was 6.5±0.53 vs 3 days in conversion vs laparoscopic group, p&lt;0.05. Statistically significant correlation noted between conversion and laparoscopic group in terms of BMI, PCN, SSI with p&lt;0.05. Recurrent UTI and visceral injury were not associated with conversion, p&gt;0.05. Conclusion: Recurrent UTI, intra-operative visceral injury was not associated with conversion. BMI, PCN, Blood transfusion and SSI was significantly high in conversion group.

Objective: YouTube has become an increasingly important platform for surgical education; however, the quality of laparoscopic surgery videos is variable. The LAParoscopic Surgery Video Educational Guidelines (LAP-VEGaS) provides a standardized framework for assessing surgical video quality. Material and Methods: A systematic search was conducted on YouTube using relevant search terms. English-narrated laparoscopic radical nephrectomy videos were included. Each video was evaluated using the 9-item core LAP-VEGaS checklist. Results: Twenty-one videos were included. The mean LAP-VEGaS score was 9.14 ± 3.72 (range 3–16). Videos originated from 11 different countries, with India contributing 38.1% (n=8). No significant correlation was found between popularity metrics and educational quality (p&gt;0.05). Conclusion: Laparoscopic radical nephrectomy videos on YouTube demonstrate a moderate level of educational quality. The lack of association between popularity and educational value highlights the necessity of quality assessment tools in surgical education.