[The anterior subcostal transperitoneal approach in urological practice (author's transl)]

Fifty-three surgical operations, including 43 enlarged nephrectomies for cancer, were conducted employing the anterior transperitoneal approach along the costal margin. This technique has been used for the last 4 years for excision of renal cancers, as well as certain difficult nephrectomies (pyonephrosis, repeated kidney operations), and for surgery on the renal vessels, the adrenals, and the peri-aortic lymphatics. The approach is solid and easy to enlarge, and gives direct access to the diaphragm, the large vessels, the renal pedicle, and the upper pole of the kidney. As only the abdomen is incised, morbidity is low.