Minimally invasive ablative technique for the treatment of small renal masses

Minimally invasive nephron sparing techniques are becoming popular treatment modalities in the face of smaller renal tumours diagnosed in an increasingly elderly population. Techniques include cryoablation and radiofrequency ablation, delivered via percutaneous or laparoscopic approaches. Laparoscopic cryoablation shows the lowest recurrence rates but this must be balanced against higher morbidity compared to the percutaneous approaches. To date, studies are limited by lack of biopsy data and accurate measurement of the effects of treatment on renal function. Laparoscopic partial nephrectomy represents the main minimally invasive alternative to these ablative techniques, but remains a technically challenging procedure. In the short term renal cryoablation and RFA appear to represent safe, effective minimally invasive nephron sparing techniques in the treatment of small renal tumours. Further studies examining long term recurrence rates and renal outcome will help to determine the utility of these techniques in managing renal tumours.