Concurrent possibilities of minimallyinvasive surgical treatment of kidney tumours

Minimally invasive surgery in the treatment of kidney tumours has developed since the beginning of the nineties. A lot of specialized or top laparoscopic urological centres so-called "centres of excellence" have been created since the first laparoscopic radical nephrectomy (LRN). These centres have thanks to the centralization of kidney tumour patients sufficient cohorts for evaluation of operative data, operative technique and oncological results. A lot of large studies have been published so far, showing comparable oncological results with open nephrectomy and advantages of miniinvasivity ( shorter hospitalization time, less analgesia requirements, better recovery and cosmetics). LRN is considered a standard of care in the treatment of cT1-2 (≤ 8cm) renal tumours in patients who are not candidates for nephron- sparing surgery. In our department in Plzeň, we have been performing LRN since January 2003. The majority of procedures has been performed by transperitoneal approach. The first LRN in the Czech Republic was done in April 1998 within XII. Conference of Czech Urologic Society by guesting prof. Clayman. We prefer transperitoneal to extraperitoneal approach in our department. The transperitoneal approach provides a larger working space, better anatomical and topographical orientation.We perform..