ABSTRACT
Since the first description of laparoscopic nephrectomy performed by Clayman et al. in 1990, there has been great enthusiasm for employing endoscopic techniques to treat renal disease processes (1). The natural progression from treating benign disease states to more complex malignancies has followed. In fact, in 2004, the majority of renal tumors are treated laparoscopically. The transperitoneal approach was the first and, by many accounts, the traditional approach in addressing renal tumors. Where there was debate in the past on whether an adequate cancer result could be obtained with laparoscopic technique, long-term follow-up has shown that laparoscopic intervention produces reproducible and acceptable results with regard to cancer control (2-7). Laparoscopic nephrectomy also results in decreased postoperative pain, a reduction in analgesic requirement, a decline in hospital stay, and a quicker overall recovery (2,6,8-10). The indications for performing a radical nephrectomy have also been refined. Many smaller lesions today are treated with laparoscopic partial nephrectomy with excellent long-term disease-free survival rather than proceeding with complete organ removal (11-14).
