POTENTIAL OF LAPAROSCOPY AND RETROPERITONEOSCOPY IN THE TREATMENT OF RENAL PARENCHYMAL TUMOURS
PART I - NEPHRECTOMY

Czech version

Authors: doc. MUDr. Milan Hora, Ph.D.; MUDr. Jiří Klečka
Authors‘ workplace: Urologická klinika LF UK a FN Plzeň
Published in: Urol List 2005; 3(3): 29-34

Overview

Objective, methodology:
The paper provides a summary of current state of knowledge on minimally invasive nephrectomy for parenchymal tumour. A review of relevant literature is complemented with the authors' own experience in introducing the above technique in their practice.

Results:
A well defined, safe and reproducible LRN technique has been developed by now. LRN can be considered the golden standard for T1 category tumours. Equivalent to LRN is the retroperitoneoscopic technique. A standardized procedure has been developed for retroperitoneoscopic radical nephrectomy too, but it is technically more demanding. Therefore it is rather advisable in imperative cases, especially for post-surgical adhesions in the abdominal cavity. Some urologists prefer hand-assisted LRN, but the prospects for this variant are not high. Recently described minilaparotomic nephrectomy, which might compete with LRN, has not yet become widely accepted worldwide.

Conclusion:
The introduction of LRN as the golden standard in the treatment of T1 renal tumours has brought to an end the era of urology in which nephrectomy was considered a relatively simple surgery to be practiced by any department of urology or by less-experienced surgeons. The introduction of LRN in the Czech Republic will impose the need to concentrate this type of surgery in major hospital facilities.

KEY WORDS:
laparoscopy, renal tumour, nephrectomy, retroperitoneoscopy

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