Posterior surgical approach to the kidney and ureter

The posterior surgical approach allows certain operations on the upper urinary tract to be performed more rapidly, with optimum exposure and with diminished morbidity. In particular, the lumbotomy incision is excellent for bilateral nephrectomy, open renal biopsy, simple nephrectomy for benign disease, pyelolithotomy, pyeloplasty and upper third ureterolithotomy. The operative technique is reviewed, and the advantages and limitations of this approach are discussed.