title: Laparoscopic radical nephrectomy: the Nagoya experience.
abstract: OBJECTIVE
  We evaluated the efficacy of laparoscopic radical nephrectomy for removing kidneys with small volume renal cell carcinoma.
  
  
  METHODS
  25 patients (19 men and 6 women, mean age 59) who had a kidney with small volume renal cell carcinoma (diameter less than 5 cm.), underwent laparoscopic radical nephrectomy. The kidney was dissected laparoscopically together with the adrenal gland, perirenal fatty tissue and Gerota's fascia. In 11 patients, we used the transperitoneal approach and in the remaining 14 we used the retroperitoneal approach, in which a working space is created by finger and balloon dissection. We maneuvered the kidney into the laparoscopy sack, which was then removed through an additional 5 to 6 cm. incision.
  
  
  RESULTS
  All 25 kidneys were removed successfully. Mean operation time was 5.3 hours and mean estimated blood loss was 335 ml. There were 5 complications, including a patient who suffered an injury to the duodenum, which was treated by open duodenojejunostomy. Full convalescence occurred at an average 23 days. No metastatic disease, no local recurrence and no seeding at the port sites occurred during the followup of 7 to 49 months (mean, 22 months).
  
  
  CONCLUSIONS
  Laparoscopic radical nephrectomy is recommended as a minimally invasive procedure for removing kidneys with small volume renal cell carcinoma.
authors.affiliation: Department of Urology, Komaki Shimin Hospital, Okazaki City Hospital, Komaki-shi, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Ono
authors.forename: N
authors.initials: N
authors.lastname: Katoh
authors.forename: T
authors.initials: T
authors.lastname: Kinukawa
authors.forename: O
authors.initials: O
authors.lastname: Matsuura
authors.forename: S
authors.initials: S
authors.lastname: Ohshima
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*