Modified transperitoneal laparoscopic partial nephrectomy for posterior renal tumor

Abstract

Objectives

To describe a modified laparoscopic partial nephrectomy combining the advantages of a transperitoneal approach with lumboscopic access for a posterolateral tumor.

Materials and methods

A patient with a 28-mm posterolateral left renal tumor underwent surgery. Three anterior transperitoneal trocars were used for mobilization of the bowel and Gerota fascia, dissection of the renal pedicle, and dissection of the retroperitoneal space. Two additional trocars, positioned above the iliac crest and on the posterior axillary line, respectively, were used to gain lumbar access and perform the tumor resection, followed by a two-layer renorrhaphy.

Results

The operative time was 150 min, the ischemia time was 17 min, and no complications were reported. The pathological report described a 27-mm clear cell carcinoma with negative surgical margins.

Conclusion

Our partial nephrectomy technique offers a straightforward approach to posterolateral tumors, integrating the advantages of both transperitoneal and lumboscopic access.