Anterior transperitoneal laparoscopic approach of retroperitoneal tumour - clinical case

We present our personal experience in the anterior transperitoneal laparoscopic approach of a retroperitoneal tumour.The case we have in view is that of a 48-year old female patient P.V., with congenital single left kidney. The patient has a retroperitoneal tumour mass of the right flank. Following investigations (ultrasound, CT with contrast), the tumour appeared well defined, of small dimensions (approximately 6-7cm diameter) and without anatomical relationships with large retroperitoneal vessels (inferior vena cava). For the laparoscopic excision of the tumour, we used an operating device adapted from the one used in right hemi-colectomy. After the coloparietal dissection, the access into the right retroperitoneal flank by means of laparoscopy is achieved by applying our procedure.The surgical intervention was quick and of a minimally invasive nature. Postoperative evolution was favourable, without any complications; the patient was discharged after 48 hours. In anatomic situations where the tumour anatomy is well defined and its size is acceptable, without dangerous anatomic relationships with large retroperitoneal vessels, attempted laparoscopic transperitoneal removal is the preferred option.