Laparoscopic retroperitoneal extirpative and reconstructive renal surgery.

Retroperitoneal laparoscopy for renal surgery is a viable and versatile alternative to transperitoneal access. Location of the kidneys in the retroperitoneum makes it an attractive approach. The development of both approaches paralleled during the last two decades; however, retroperitoneal laparoscopy witnessed a steep learning curve because of the constraint of working space, lack of obvious landmarks, and appropriate instrumentations. This approach has several advantages and is currently being used for extirpative and reconstructive procedures for various renal pathologic conditions. After creation of retroperitoneal space, the techniques can be tailored to the desired indication for successful culmination. The learning curve can be shortened by adequate training; subsequently, with experience, this can be used proficiently.