International Surgery Journal | April 2021 | Vol 8 | Issue 4 Page 1329
International Surgery Journal
Shetty S et al. Int Surg J. 2021 Apr;8(4):1329-1333
http://www.ijsurgery.com
pISSN 2349-3305 | eISSN 2349-2902
Case Report
Re-visiting laparoscopic radical nephrectomy- the past, present and
future: case report and review of literature
Saiprasad Shetty*, Prakash Shetty, Abhijit Joshi
INTRODUCTION
The first laparoscopic nephrectomy was performed in
1990. This was rapidly accepted world-wide and became a
viable alternative for the surgical management of T1 renal
tumors. LRN is considered as the gold standard for
management of patients with T1 renal cell carcinoma
(RCC) who cannot be considered for nephron-sparing
surgery (NSS). Over time, minimally invasive approaches
have been also used for excision of larger lesions. The
standard advantages of laparoscopy over open surgical
approaches are well known. Intra-operative blood loss,
time of hospital stay, analgesia used, and time of
convalescence have all been shown to be shorter in
laparoscopic surgery, without compromising on
oncological outcomes. For these reasons, laparoscopic
radical nephrectomy has now been even for renal masses
more than seven centimetres in size.
CASE REPORT
We hereby present a case of a 75-year-old female who
presented to the OPD with chief complaint of painless
haematuria on and off, for 1 month. She had no other
complaints. She was a known case of diabetes with no
history of any previous surgeries. Her lab reports were as
follows: Hb- 9.7 g/dl, tlc- 8,500 /mm
3
, creatinine 1.2
mg/dl, urine routine examination showed plenty RBCs and
urine culture showed no growth. She was planned for
Contrast Enhanced Computed Tomography (CECT) of the
abdomen which showed a growth in the upper pole of the
left kidney which measured approximately 4×3×2.5 cm
ABSTRACT
Laparoscopic radical nephrectomy (LRN) has since long proven its therapeautic credentials in the field of renal cancer.
Since the first reported case of LRN thirty years ago, it has stood the test of time. With the development of newer energy
sources, better optics and ergonomically superior instruments, it has further established itself as the milestone or the
landmark with which all future variations in the field of renal cancer surgery would be compared. Newer procedures
such as retroperitoneoscopic radical nephrectomy, laparoscopic partial nephrectomy, robotic radical nephrectomy and
partial nephrectomy and few other more conservative procedures such as radio-frequency ablation, cryo-ablation etc.
are examples of these variations. In this paper, we present a case report on laparoscopic radical nephrectomy, review
literature on the subject and delve into comparisons with newer procedures vis-à-vis their individual pros and cons.
Through this study we are portraying the past, present and future of laparoscopic radical nephrectomy.
Keywords: Laparoscopic radical nephrectomy, Retroperitoneoscopic, Robotic, Partial nephrectomy, Cryoablation,
Radiofrequency ablation
Departments of Surgery and Urology, Dr. L H Hiranandani Hospital, Powai, Mumbai, India
Received: 07 December 2020
Revised: 16 March 2021
Accepted: 17 March 2021
*Correspondence:
Dr. Saiprasad Shetty,
E-mail: saishetty1@gmail.com
Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under
the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial
use, distribution, and reproduction in any medium, provided the original work is properly cited.
DOI: https://dx.doi.org/10.18203/2349-2902.isj20211318