Laparoscopic nephrectomy is commonly performed by the transperitoneal approach. Primarily, this is because the transperitoneal route offers a larger working space and well-defined anatomic landmarks. The kidney, however, is a retroperitoneal organ. Accordingly, a direct “retroperitoneoscopic” approach for performing laparoscopic nephrectomy seems logical and has inherent appeal. Indeed, laparoscopic nephrectomy for benign disease increasingly is being performed by the retroperitoneal approach at various urologic laparoscopic centers worldwide.<sup>11 Gill I.S. Retroperitoneal and pelvic extraperitoneal laparoscopy: An international perspective [abstract no. P17-504] J Endourol 1996 ;  10 : S186

Cliccare qui per andare alla sezione Riferimenti</sup>

This article details the historical background, indications, contraindications, applied surgical anatomy, and the author's technique of retroperitoneoscopic nephrectomy. Technical caveats, intraoperative trouble-shooting, and current worldwide results of retroperitoneoscopic nephrectomy are presented. A brief description of retroperitoneoscopic radical nephrectomy, with our current results at the Cleveland Clinic, is followed by a discussion of the pros and cons and the future potential of retroperitoneoscopic renal surgery. Because the optimal technique of retroperitoneoscopic nephrectomy is still evolving, the recommendations herein necessarily reflect the author's personal bias.