Simultaneous bilateral laparoscopic nephrectomy in a child with peritoneal catheter dialysis using a 4-port trans-abdominal technique

We present the case of an 11-year-old girl with end-stage renal disease and a previously-inserted peritoneal dialysis catheter who underwent a bilateral transperitoneal laparoscopic nephrectomy for hypertension refractory to medical treatment. We employed a 4-port transperitoneal technique using the first detached kidney to occlude the ipsilateral abdominal wall access port during the contralateral nephrectomy to avoid gas/fluid leak and to facilitate location of the first kidney at the end of the surgery. The patient had no morbidity and was able to resume use of the peritoneal dialysis catheter 5 days after the surgery.