Retroperitoneoscopic nephrectomy for symptomatic hydronephrosis using a SAND balloon catheter

Introduction: A retroperitoneoscopic nephrectomy (RN) for symptomatic hydronephrosis (SH) is a challenging procedure because of the limited working space. This report describes a specific technical modification for efficient and successful RN for SH by using the SAND balloon catheter. Patient and Methods: A 38-year-old woman underwent RN for SH caused by extrinsic compression of the ureter by a pelvic endometriosis. The SAND balloon catheter was directly inserted into the expanded hydronephrotic sac, and the liquid was extracted, appropriately. Urine leakage from the hydronephrotic sac could be avoided because the puncture site was sealed firmly between the two adjacent balloons at the tip of the catheter. Disposal counter traction using the catheter facilitated the mobilization of the hydronephrotic sac. Results: The patient was discharged 3 days after undergoing this procedure. Conclusions: This method improves the surgeon's vision and facilitates resection without causing any injury to the hydronephrotic sac wall during RN.