Laparoscopic and Retroperitoneoscopic Radical Nephrectomy: Techniques and Outcome

Abstract

Objectives Minimally invasive radical nephrectomy has gained widespread acceptance in the urological community. Both the laparoscopic and retroperitoneoscopic approach have been established and advocated for radical surgery. Our experience and the advantages and indications for each procedure are analyzed in this article. Methods Data from two clinics that routinely perform either laparoscopic or retroperitoneoscopic nephrectomy for localized tumours are compared. At the Charité Urology Clinic, Campus Mitte, the transperitoneal laparoscopic approach is the preferred technique for T1 and selected T2 tumours. At the Basel University Hospital, the preferred technique for patients with clinical T1 renal tumours is retroperitoneoscopy. Results During a period of 5 yr, 163 patients underwent minimally invasive nephrectomy using either the laparoscopic ( n = 125) or the retroperitoneoscopic ( n = 38) approach. There were no major intraoperative complications with either technique. Intra- and postoperative data were comparable and oncological outcome was similar for both techniques, at a mean follow-up of 25 mo. Conclusions Both retro- and transperitoneal approaches of minimally invasive radical nephrectomy are safe procedures that achieve the same standard and duplicate oncological principles established for open surgery.