Laparoscopic nephrectomy: present state and future developments

Laparoscopy has been a valuable tool in gynecologic practice for many years but it is only recently that this technology has been applied to urological surgery.1 Initially laparoscopy was used in urology only for di- agnostic purposes; however, following the success of laparoscopic cholecystectomy,' the technique was utilized to perform therapeutic procedures such as varicocelectomy and pelvic lymphadenectomy.v' Open surgery has been the standard for nephrectomy for over 100 years and the techniques, results, and complica- tions have been well documented in surgical texts. Laparoscopic nephrectomy is also a relatively new appli- cation, having only been first described in 1991.5 This article will review the current status of laparoscopic nephrectomy and speculate on its future role. The pros and cons of the laparoscopic technique when com- pared to open nephrectomy will also be discussed.