Laparoscopic nephrectomy without morcellation for renal cell carcinoma: report of initial 2 cases.

We recently developed a new laparoscopic procedure of nephrectomy for renal cell carcinoma and successfully removed the kidney in 2 patients. A carbon dioxide pneumoperitoneum is induced and 5 trocars are introduced into the abdominal cavity through the lateral abdominal wall. The kidney is removed en bloc together with the adrenal gland, perirenal fat and Gerota's fascia. The kidney is placed into a sack, which is pulled out through a 5 cm. incision in the abdominal wall without morcellation to allow for complete pathological examination. With this procedure right nephrectomy was performed in a 44-year-old man with a 2.5 cm. tumor in the right kidney and left nephrectomy was done in a 52-year-old man with a 2.5 cm. tumor in the left kidney. Operative time was 379 minutes and 464 minutes, respectively. There were no complications in either case. This procedure may be indicated in patients with small volume renal cell carcinoma.