[Laparoscopic surgery for renal carcinomas]

We reviewed the indications and clinical outcome of laparoscopic nephrectomy for renal carcinomas. The most important aspect of laparoscopic nephrectomy for renal carcinomas is complete tumor removal. En bloc dissection of the tumor is easily obtained by laparoscopic surgery. However, tissue morcellation for tumor retrieval is still controversial. The indications for laparoscopic nephrectomy should be limited to early, solitary, small tumors (tumor size less than 5-6 cm in diameter) with no hilar lymph node involvement, or to cytoreduction surgery on solitary tumors (less than 7-8 cm in size). Gasless laparoscopy-assisted nephrectomy with minilaparotomy is preferable for the treatment of renal carcinomas because the renal vessels can be safely prepared under direct vision, the tumor can be removed en bloc, and both hilar and paraaortic lymph node dissection can be performed.