Laparoscopic removal of local renal cell carcinoma recurrence.
OBJECTIVE
To describe an entirely laparoscopic technique for excising a recurrence of local renal cell carcinoma (RCC).


METHODS
The patient is placed in a full flank position. A 10-mm trocar is inserted using Hasson's technique with three additional ports in the upper abdomen. After lysis of adhesions, the psoas muscle, ureteral and gonadal vein remnants, inferior vena cava or aorta, and renal vessel stumps are dissected and isolated. The specimen, including the mass, the adrenal gland, and the ipsilateral pararenal and paracaval or para-aortic tissue within Gerota's fascia remnants, are excised en bloc and removed inside an Endocatch-II bag.


RESULTS
To date we have used this technique for excising RCC recurrences in three patients. Pathologic examination showed clear cell type RCC Fuhrman grade 2 in the specimens of two patients and chromophobe type in one. No patient has had further recurrence after 50, 38 and 12 months of follow-up.


CONCLUSIONS
An entirely laparoscopic surgical approach for excising local RCC recurrence has not, to our knowledge, been previously described. This method can be effectively applied while adhering to oncologic principles, with minimal blood loss and low morbidity.
Tsivian
Alexander
A
Departments of Urologic Surgery and Surgery B, Wolfson Medical Center, Holon, Israel.
Benjamin
Shalva
S
Shtricker
Avraham
A
Tsivian
Matvey
M
Kyzer
Shlomo
S
Sidi
A Ami
AA
D000368:Aged; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome