title: [Retroperitoneal endoscopic nephrectomy].
abstract: OBJECTIVE
  Nephrectomy is probably the most widely accepted procedure for the application of laparoscopic techniques in urology. The great advantages of laparoscopy over conventional approaches have justified its indication for different renal extirpative procedures: atrophy, renal carcinoma, transitional cell carcinoma, polycystic kidney disease, living kidney donation for transplantation and partial nephrectomies. The objective of this article is to describe the techniques and advantages of laparoscopic nephrectomy through a retroperitoneoscopic approach, demonstrating that it is an effective option for the majority of cases in which extraction of the kidney is required.
  
  
  METHODS
  Between January 1991 and January 2001 107 patients with different renal conditions were treated at the Instituto Docente de Urología (IDU) using transperitoneal (36 patients) or retroperitoneal (71 patients) laparoscopic access. Indications for laparoscopic approach included atrophy, living donation, renal carcinoma, urothelial tumour, polycystic kidney disease and partial nephrectomy.
  
  
  RESULTS
  Nephrectomy trough a transperitoneal approach was completed in 33 (91.6%) of 36 patients, being necessary to convert to conventional surgery in the remaining 3 cases (8.3%). Retroperitoneoscopic approach was successful in all cases (100%).
  
  
  CONCLUSIONS
  The retroperitoneoscopic approach is a simple procedure that allows its implementation in the majority of patients in which there is an indication for nephrectomy. Retroperitoneoscopy provides a rapid recovery, minimal analgesic needs, and a short hospital stay. Finally, retroperitoneoscopic approach represents a logical evolution for conventional flank incisions, providing familiarity with surgical field landmarks and management to those urologists that incorporate this new technical modality.
authors.affiliation: Instituto Docente de Urología Avenida Carabobo c/c calle Carabobo Valencia-Estado Carabobo Venezuela. paulidu@cantv.net.ve, info@idu.com.ve
authors.forename: Paúl Antonio
authors.initials: PA
authors.lastname: Escovar Díaz
authors.forename: José Luis
authors.initials: JL
authors.lastname: García Sanz
authors.forename: Paúl Ernesto
authors.initials: PE
authors.lastname: Escovar La Riva
authors.forename: Fernando Paúl
authors.initials: FP
authors.lastname: Rodríguez Escovar
authors.forename: Antonio
authors.initials: A
authors.lastname: Escobar
authors.forename: Manuel
authors.initials: M
authors.lastname: Rey Pacheco
authors.forename: Juan Ricardo
authors.initials: JR
authors.lastname: López Escalante
authors.forename: Pablo Emilio
authors.initials: PE
authors.lastname: Sánchez
authors.forename: Rafael
authors.initials: R
authors.lastname: Cuervo Arias
authors.forename: José Gregorio
authors.initials: JG
authors.lastname: Montilla
mesh_terms: D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D019520:Living Donors; D009392:Nephrectomy / Q000295:instrumentation / Q000379:methods*; D007690:Polycystic Kidney Diseases / Q000601:surgery; D011187:Posture; D011300:Preoperative Care; D012187:Retroperitoneal Space; D013525:Surgical Instruments; D020858:Tissue and Organ Harvesting / Q000379:methods; D014057:Tomography, X-Ray Computed; D014513:Ureter / Q000601:surgery