IPEG 2018 - ROBOTIC NEPHROPEXY FOR THE TREATMENT OF NEPHROPTOSIS

demonstrates our technique of robotic nephropexy for the treatment of nephrotosis. Our patient is a 16-year-old female with a history of a right upper quadrant abdominal mass noted 6 months prior to initial evaluation. The mass is mobile within the abdomen and right flank and most prominent when the patient is in an erect position. She has experienced significant intermittent pain, primarily when the mass is palpable in the lower portion of the abdomen. CT scan failed to demonstrate a mass within the abdomen and retroperitoneum. Abdominal films were obtained with the patient supine and erect. The right renal shadow was visible and was noted to be in a dependent position on erect imaging. Nephrotosis is defined as descent of the symptomatic kidney by two vertebral bodies. Pain is a result of transient ischemia or urinary obstruction. Prior to surgical intervention, the surgeon should confirm the presence of either obstruction, decreased renal blood flow, or pain associated with renal descent. The purpose of our video is to highlight our technique of performing a nephropexy in a running fashion using the da Vinci surgical system. Operative time was 135 minutes. There were no immediate postoperative complications. The patient was discharged on postoperative day one. The patient followed up in 6 months. The patient reports minimal mobility of the kidney, and the kidney is not palpable on exam. She reports improvement of her prior right upper quadrant and flank pain.