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Laparoscopic partial nephrectomy: an evolving standard

Nature Clinical Practice Urology volume 4, pages 116–117 (2007)Cite this article

Partial nephrectomy is the current standard treatment for patients with a small (≤4 cm) enhancing renal mass.1,2,3 The purpose of this article is not to debate whether renal masses that are amenable to partial nephrectomy should be treated laparoscopically or by open surgery. The type of surgical procedure performed should depend on the characteristics of the tumor, the preference of the patient, and—probably most importantly—the inclination and expertise of the surgeon. On the basis of our personal experience with laparoscopic partial nephrectomy (LPN) in almost 700 patients, we believe that LPN is now ready for widespread use and can be performed reproducibly and reliably, even for complex renal masses, with equivalent oncologic and renal functional outcomes to those of open surgery.

The oncologic and functional results of open partial nephrectomy (OPN) are excellent. At the same time, the morbidity associated with an open flank incision can be considerable,4 and the chance that a small renal mass will ultimately be proven benign or indolent is approximately 30%. As such, subjecting all of these patients to a large, muscle-cutting, open flank incision might be suboptimal. We wish to emphasize, however, that the morbidity associated with a flank incision pales in comparison to that associated with a poorly performed nephron-sparing procedure, open or laparoscopic.

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Authors and Affiliations

  1. M Aron is a Clinical Fellow, G-P Haber is a Research Fellow, and IS Gill is Professor and Vice-Chairman at the Glickman Urological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.,

    Monish Aron, Georges-Pascal Haber & Inderbir S Gill

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  1. Monish Aron
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  2. Georges-Pascal Haber
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  3. Inderbir S Gill
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Correspondence to Inderbir S Gill.

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The authors declare no competing financial interests.

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Aron, M., Haber, GP. & Gill, I. Laparoscopic partial nephrectomy: an evolving standard. Nat Rev Urol 4, 116–117 (2007). https://doi.org/10.1038/ncpuro0734

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