ABSTRACT
Introduction 64
Indications and Contraindications 64
Preoperative Patient Evaluation and Preparation 65
Techniques 65
Transperitoneal Approach 65
Hand-Assisted Transperitoneal Approach 68
Retroperitoneal Approach 69
Postoperative Patient Management 70
Results 71
Transperitoneal Approach 71
Complications of Standard Transperitoneal Approach 72
Hand-Assisted Transperitoneal Approach 72
Complications of Hand-Assisted Transperitoneal Approach 73
Retroperitoneal Approach 73
Complications of Retroperitoneal Approach 73
Comparison of the Various Laparoscopic Techniques 74
Laparoscopic Partial Nephrectomy for RCC 74
Overview of Techniques 74
Clinical Results 74
Conclusions 75
References 76
INTRODUCTION
Renal cell carcinoma (RCC) accounts for 3% of all adult malignancies, and 23,000 to 28,000 new cases are diagnosed in the USA each year (1,2). Surgical
resection has been the most effective management to cure localized RCC, and
radical nephrectomy has long been considered as the gold-standard (1).
Radical nephrectomy requires en bloc removal of the affected kidney with the
enveloping Gerota’s fascia.
