Retroperitoneoscopic radiofrequency ablation of a solid renal mass

Purpose: To report a new technique for radiofrequency (RF) ablation of a so lid renal mass. Patient and Methods: An 83-year-old man with a history of chronic renal ins ufficiency was found to have solid mass in the right kidney. Retroperitoneo scopic localization of the renal mass was accomplished using intraoperative ultrasonography. The lesion was treated with a 14-gauge RITA (R) Starburst (TM) XL probe (Rita Medical Systems, Inc., Mountain View, CA). Results: The total treatment time included two cycles of 5.5 minutes. There were no intraoperative complications. Tissue desiccation was noted during treatment. A CT scan 48 hours after ablation showed a decrease in the densi ty of the lesion suggestive of coagulation necrosis. The postoperative hosp ital course was uneventful. Conclusion: The retroperitoneal laparoscopic technique is a feasible approa ch to performing RF ablation of a solid renal mass. It facilitates direct i nsertion of the RF probe, allows viewing and avoidance of adjacent structur es such as bowel, and permits better staging by enabling biopsy of perirena l fatty tissue.