[Laparoscopic nephrectomy with vaginal extraction in obese or overweight patients: the end of wound complications?]. / Néphrectomies laparoscopiques avec extraction vaginale chez la patiente obèse ou en surcharge pondérale : la fin des complications pariétales ?

PURPOSE: To study the feasibility and to present results of laparoscopic nephrectomy with vaginal extraction in overweight or obese patients. PATIENTS AND METHODS: Three patients having BMI>28 kg/m(2) underwent surgery. Median age was 56 years, median BMI was 44.4. Medical history included for the three patients type 2 diabetes mellitus and arterial hypertension. Two of the three patients were multiparous, one was nulliparous. Patients underwent standard laparoscopic nephrectomy with vaginal extraction of the specimen through a short incision of the posterior vaginal fornix. Feeding was normal on the first operating day. No morphine was prescribed during hospitalization stay. RESULTS: No intraoperative complication occurred. Mean procedure time was 224 min. Mean blood loss was 140 mL. Postoperative period was uneventful and walking was normal on the first operating day. Hospitalization stays were 2, 3 and 5 days. One month follow up found no complication including normal sexual activity. CONCLUSION: Laparoscopic nephrectomy with vaginal extraction is a feasible technique in obese or overweight patients. Wound morbidity (infection, hernia) is reduced due to the small abdominal incisions.