New Method in Laparoscopic Surgery of Xanthogranulomatous Pyelonephritis

Laparoscopic surgery for Xanthogranulomatous pyelonephritis (XGP) is a difficult one so it seems that our experience may be helpful in other similar surgeries. The patient was a 75 years old woman who had right flank pain, several stones were observed in her kidney via IVU (Intra Venous Urogram). The patient underwent transperitoneal laparoscopic nephrectomy and on pathology, XGP was reported. Total nephrectomy is the treatment of choice for XGP, but it is usually contraindicated for laparoscopic or retroperitoneoscopic techniques. We propose that in laparoscopic surgery of XGP, the ureter should be preserved until the end of procedure in order to use it as a handle. Also the adhesion of the superoposterior of kidney should not be free before ligaturing the pedicle. We suggest that in laparoscopic surgery of XPG, in case of difficulties in dissection of artery and vein, we could initially clamp and cut the vein, then ligator and cut the