ABSTRACT
The indication for laparoscopic tumor nephrectomy for small renal masses (< 7 cm, category T1) is similar to open surgery and mainly includes centrally localized tumors in which an organ-preserving concept is technically not possible. Renal masses between 7 and 10 cm can be treated with the laparoscopic approach, but the size of the renal mass often limits access to the renal hilum and the intraoperative handling of the organ. Therefore, indication should be strict and the surgeon should be well experienced with laparoscopic procedures. Renal masses larger than 10 cm or tumors with preoperatively diagnosed renal or caval vein involvement should not be treated by laparoscopy. Here, experienced centers are currently investigating the feasibility of the laparoscopic approach. It is important to identify the layer between mesocolon and kidney by pulling the colon median with a grasper.
