Abstract
The retroperitoneal and extraperitoneal pelvic approach are related with advantages in terms of avoiding intraperitoneal adhesions from previous surgery, formation of new intraperitoneal adhesions and tamponade of any urine or blood leakage extraperitoneally. Retroperitoneal renal surgery has been associated with shorter operative and hospitalization times. In the case of partial nephrectomy, the retroperitoneal approach is preferred by the majority of the surgeons for the management of tumors located at the posterior surface of the kidney. The anatomy related to the retroperitoneal and extraperitoneal approach does not represent a challenge to the urologist. Some important tricks in the trocar placement and anatomical orientation should be considered. Every surgeon should have knowledge of these advantages and disadvantages as well as the anatomy in order to set the appropriate indication and to perform surgery without access related difficulties.
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