Transverse "S" laparotomy for radical nephrectomy and upper retroperitoneal access

A modified transverse laparotomy is described that allows for safe removal of bulky kidney or adrenal tumors and suprarenal hilar lesions in cases of metastatic testicular cancer. The full exposure of the upper retroperitoneal area provided by this access obviates the need for a thoracoabdominal incision with its attendant drawbacks. Our experience with the transverse S laparotomy in more than 80 patients with large renal or retroperitoneal tumors confirmed the wide local exposure obtained, short hospital stay and absence of pulmonary complications that can occur after the thoracoabdominal approach.