Laparoscopic Nephron-Sparing Calycectomy for Treating Fraley's Syndrome

Abstract

Background/Aims/Objectives: Various nephron-sparing approaches were described as part of surgical management for Fraley's syndrome, a rare anatomic variant of the renal vascular anatomy that compresses the upper pole infundibulum resulting in an upper calyceal obstruction and dilatation, with symptoms of flank pain and hematuria. To date, descriptions of minimally invasive correction techniques are anecdotal.

Methods: A retroperitoneal pure laparoscopic approach using the nephron-sparing technique was chosen in the presented case.

Results: In this report, we demonstrated that if laparoscopic calycectomy is performed without clamping of renal branches, parenchymal ischemia can be completely avoided. Additionally, the preservation of renal tissue surrounding the calyx enables the preservation of the intrasinusal segmental arteries flow, thereby avoiding their accidental closure by hemostatic sutures.

Conclusions: In conclusion, Laparoscopic Nephron-Sparing Calycectomy is a safe and effective surgical procedure for the treatment of Fraley's syndrome. Consistent laparoscopic experience is required before embarking on this kind of surgery.

Keywords: Kidney; Laparoscopy; Nephron-sparing surgery; Renal pelvis; Retroperitoneoscopy; Stenosis; Surgical repair; Surgical technique.