Transperitoneal Laparoscopic Radical Nephrectomy is an Effective Procedure for Large (More Than 7 cm) Renal Masses

Abstract

Our data show that TLRN is an effective procedure for the removal larger than 7 cm renal tumors. In those patients with exceptionally big tumors planned conversion to the hand-assisted technique after laparoscopic ligation of the renal vessels enabling easier renal dissection whereas preserving the advantages of minimally invasive procedure.

Utility of Anteroposterior Diameter Ratio of Tumor and Abdomen for Laparoscopic Approach for Radical Nephrectomy in Large Renal Masses

“…Port placement is more caudal and medial than for the smaller renal masses (21) to allow for more working space. Use of larger working ports (10 and 12 mm) from the beginning of the surgery, extension of trocar port to hand-port (16) and additional port for fan retractor (22) are also helpful. All these factors point toward reaching the hilum by lifting the kidney away from the aorta on the left and vena cava on the right side to get space to mobilize the renal vessels.…”

“…All these factors point toward reaching the hilum by lifting the kidney away from the aorta on the left and vena cava on the right side to get space to mobilize the renal vessels. In fact, vascular injury and bleeding have been the most common cause of conversion in several studies (5, 14-18). In the present study, we have tried to find a simple objective parameter on imaging, which could guide Urologists to select patients with stage T2b renal masses for laparoscopic surgery.…”