Laparoscopic peritoneal fenestration and internal drainage of lymphoceles after renal transplantation

The development of a postoperative lymphocele after renal transplantation is a well-described complication that occurs with relative frequency. Management options have previously included simple aspiration, percutaneous imaging-guided drainage with catheter placement, and operative marsupialization of the cyst into the peritoneal cavity. Because these collections are often multiloculated, catheter drainage may be of limited value, and the recurrence rate is unacceptably high. The operative approach is the most definitive method and is still considered the treatment of choice. This paper describes a laparoscopic approach to peritoneal fenestration and internal drainage of lymphoceles after renal transplant surgery and recommends that this technique be considered the primary mode of therapy for this complication.