[Transabdominal laparoscopic radical nephrectomy of modified Pfannenstiel incision]

To evaluate the efficacy and safety of transperitoneal laparoscopic radical nephrectomy with the modified Pfannenstiel incision.

Between Aug. 2012 and Jul. 2013, the same surgeon performed transperitoneal laparoscopic radical nephrectomy for 12 patients with renal masses. The approach was usually performed through 3 ports or 4 ports placed in a traditional manner. After laparoscopic radical nephrectomy was completed, and the specimen was entrapped in a specimen retrieval bag, a 7 cm modified Pfannenstiel skin incision was made over the symphysis pubis, lateralized slightly toward the side of surgery.

All the procedures were completed without conversion to open radical nephrectomy. The operative time was 106 to 234 minutes and the blood loss was minimal. There was no intra- or post-operative complications. The pathological result was renal cell carcinoma. One patient died of multiple organ metastasis after 5 months. No recurrence was seen after 9 to 20 months' follow-up.

Laparoscopic radical nephrectomy with the modified Pfannenstiel incision where the kidney is removed offers the benefits of improved cosmesis over the traditional muscle-cutting extension of an upper abdominal, lateral port site. The modified Pfannenstiel incision combines the advantages of a low abdominal incision and improved cosmesis, and can be considered a potential alternative for traditional laparoscopic nephrectomy.