ABSTRACT
The indication for laparoscopic retroperitoneal lymph node dissection (RPLND) is currently controversial, especially in stage I testicular carcinoma. Some authors suggest primary chemotherapy as the treatment of choice in these patients to give maximum safety and avoid RLPND-related complications and morbidity. The indication for RPLND in stage II tumors or resection of residual masses after chemotherapy in stage III disease remains unaffected by the aforementioned considerations. In our opinion laparoscopic RPLND in stage I and II disease is a worthy tool for staging with low morbidity and, besides the guidelines, the authors always offer the opportunity for a staging procedure to the patients if indicated. Basically the laparoscopic technique mimics the steps of the open modified procedure. If residual tumor resection is performed after chemotherapy the ureter may be involved in the fibrosis surrounding the tumor.
