Retroperitoneal laparoscopic radical nephrectomy: experience of 23 cases.

INTRODUCTION

Retroperitoneal laparoscopic radical nephrectomy has recently been performed in several institutions for renal cancer. We report our experience with this type of operation and discuss the anatomy of perirenal fascial structures.

PATIENTS AND METHODS

From July 2000 to May 2002, we performed retroperitoneal laparoscopic radical nephrectomy in 23 patients. We began this operation with longitudinal cutting of two layers of the posterior renal fasciae, and removed specimens without any fascial structure.

RESULTS

Mean operative time was 203 min (range 129-314 min) with an average estimated blood loss of 113 ml (range 0-837 ml). There was 1 patient who required open conversion due to uncontrollable hemorrhage, but no complication was observed.

CONCLUSIONS

Retroperitoneal laparoscopic radical nephrectomy is a safe and reliable method when the anatomy of the perirenal fasciae is clearly understood. Long-term follow-up of patients undergoing this procedure is warranted to its effect on the prognosis of renal cancer.