Laparoscopic Nephrectomy: Retroperitoneal Approach

Laparoscopic nephrectomy was originally described using a transperitoneal approach. However, detractors have ar-gued that the transperitoneal approach provides a less direct approach to retroperitoneal structures, risks injury to intraperitoneal viscera, and results in a longer postopera-tive ileus. With the development of a variety of dissecting balloons, retroperitoneal laparoscopic nephrectomy has been demonstrated to be safe and efficacious; in particular, small, benign kidneys may be best suited to the retroperito-neal approach. A variety of centers have reported excellent results using this approach