Partial Nephrectomy

Small, incidental renal tumors are being diagnosed with increasing frequency as a result of improved imaging technologies. In these cases, radical nephrectomy is not the surgery of choice. Partial nephrectomy affords long-term oncologic outcomes similar to those in radical nephrectomy with the benefit of preserving and maintaining a high glomerular filtration rate. Laparoscopic partial nephrectomy is an accepted minimally invasive nephron-sparing alternative for selected renal masses. As more surgeons develop the necessary confidence and expertise in laparoscopic surgery, the number of complex reconstructive and oncologic procedures performed laparoscopically will likely rise.

This chapter describes one technique for laparoscopic partial nephrectomy, including its indications and contraindications, the necessary instrumentation, and technical tips and nuances. In general, this technique is applicable to either the transperitoneal or retroperitoneal approach, with any surgical differences noted accordingly.