Retroperitoneal Laparoscopic Radical Nephrectomy for Renal Cell Carcinoma: A Report on 2 Initial Cases

We report our experience with retroperitoneal laparoscopic radical nephrectomy in 2 patients with renal cell carcinoma. In this procedure, a working space in the retroperitoneum is created using the blunt balloon dissection technique. Carbon dioxide insufflation is performed, and 4 trocars are inserted into the retroperitoneal cavity through the lateral abdominal wall. The kidney is removed together with the perirenal fat and Gerota's fascia in a muscle-splitting fashion. Using this procedure, a right nephrectomy was performed in a 65-year-old man with a 2.4-cm tumor and in a 54-year-old woman with a 3.5-cm tumor. Operative time was 220 min and 195 min, respectively, and estimated blood loss was 10 mL and 115 mL, respectively. There were no major perioperative complications. Although a long-term follow-up is necessary to evaluate the efficacy of this procedure, it will probably become a standard treatment modality for localized renal cell carcinoma