Laparoscopic nephrectomy: current status.

In this manuscript we describe our initial experience with 22 patients who underwent laparoscopic nephrectomy at our institution. Of the 22 patients, 16 patients had benign disease, and 6 patients had malignant disease. Of the 6 patients with malignancy, 3 patients underwent laparoscopic nephroureterectomy for transitional cell cancer of the upper urinary tract. In 21 patients, a transabdominal approach was utilized, whereas 1 patient underwent laparoscopic nephrectomy using an entirely retroperitoneal approach. Laparoscopic nephrectomy showed lengthy operative times, but resulted in reduced postoperative discomfort, shortened hospital stay, and rapid convalescence. As laparoscopic nephrectomy has been performed with reproducible success by various other groups worldwide, further refinements in surgical technique, paired with advances in laparoscopic instruments designed for stapling and suturing, will most likely result in an increasing application of the principles of laparoscopy to diseases of the kidney, renal pelvis and ureter.