[Laparoscopic ablation of renal cysts].

The therapeutic indications for renal cysts, a pathology observed in more than 50% of subjects aged over fifty years, are currently limited to their symptomatic forms or those of uncertain diagnosis. The approach has changed from the unroofing procedure to percutaneous sclerotherapy and, thereafter, to percutaneous resection or endourological marsupialization to the urinary tract. Only a year ago, some isolated cases of laparoscopic treatment of renal cysts were reported. Our experience of 13 cases using this latter technique is described. The procedure is performed under general intravenous anesthesia (with intubation), using three or four laparoscopic ports (one of 11 mm and 5 mm for the rest), electric scissors, two grasping forceps and an aspiration/irrigation system. After opening the parietocolic space at the cyst level, a 4 cm window is dissected in the peritoneal tissue, on its wall. After punctioning and emptying the cyst, we explore it inside and dissect its free wall for complete excision. The early and late results (some cases have a follow-up of more than one year) are excellent. For this reason, we advocate the use of this procedure for symptomatic renal cysts over 8 cm in diameter that do not present an exclusively intrarenal development.