ABSTRACT
Indications for retroperitoneoscopic tumor nephrectomy are organ-confined renal tumors, stage T1-(2). Large tumor size is only a relative contraindication, which depends on the comfort level of the surgeon and the individual characteristics of the tumor. Contraindications include vena caval thrombus, bulky lymphadenopathy, locally invasive tumors, and previous excessive lumbal surgery. The patient reports to the hospital 1 day before surgery and undergoes routine preoperative evaluation including blood analysis, chest X-ray, and electrocardiography. Special bowel preparation is not necessary for retroperitoneoscopy. To prevent thrombosis the patient receives subcutaneous low-molecular-weight heparin on the evening before the operation. One hour preoperatively broad-spectrum antibiotics are administered intravenously. Following general anesthesia and Foley catheter placement, the patient is safely secured to the operating table in a standard full-flank position.
