[Trans-duodenal-recess laparoscopic nephrectomy and adrenalectomy. Preliminary report]

We report two cases of left nephrectomy and one case of left adrenalectomy with our new laparoscopic procedure. We treated the left renal vein first using trans-duodenal-recess approach. The left renal vein could be detected after an incision into the parietal peritoneum on the left side of the duodenojejunal flexure (duodenal-recess) was performed. When the nephrectomy was performed, the renal artery and vein were transected using endoGIA. When the left adrenalectomy was performed, the adrenal vein was clipped and divide after lysis of the left renal vein. Our new method allowed the renal vein to be treated first, so the remainder of the operation could be performed without the risk of bleeding.