Simple nephrectomy: Retroperitoneal approach

Direct extraperitoneal surgery has become the preferred approach to laparos copic nephrectomy since the introduction of the balloon dilation method. Th e lateral decubitus position provides good exposure, but the prone position is used at some centers to gain better exposure with the aid of gravity. T he open conversion rate ranges from 0 to 16% and the complication rate from 5% to 45%, with most complications being minor. Retroperitoneal laparoscop ic simple nephrectomy is definitely superior to open nephrectomy as judged by analgesic use and recovery time. The higher complication rate and lower efficiency can be taken care of by experience and proper case selection.