Laparoscopic radical nephrectomy

Laparoscopic radical nephrectomy has gained in popularity as an accepted tr eatment modality for localized renal cell carcinoma at many centers worldwi de. Laparoscopic radical nephrectomy may be performed via a transperitoneal or retroperitoneal approach. Mostly, the transperitoneal approach is used. Current indications for laparoscopic radical nephrectomy include patients with T-1-T3aN0M0 renal tumors. Herein, transperitoneal as well as retroperi toneal laparoscopic approaches are described. Surgical outcomes and complic ations from published series are reviewed with comparison to open surgery. Special related concerns as oncologic principles, organ retrieval, lymphade nectomy, and concomitant adrenalcetomy are addressed. In conclusion, laparo scopic radical nephrectomy is now established with considerable advantages; decreased postoperative morbidity, decreased analgesic requirements, impro ved cosmesis, shorter hospital stay and convalescence. Although no long-ter m follow-up is available, short and intermediate follow-up results confirm the effectiveness of laparoscopic radical nephrectomy. Copyright (C) 2001 S . Karger AG, Basel.