Objective: Partial nephrectomy is a safe procedure in renal tumors less than 4 cm. The laparoscopic technique is one of the most complex surgeries in urology. We present our experience in 12 years with open and laparoscopic technique. Material and Methods: The analyzed period covers from 1995 to 2006, during which 96 parenchymal sparing renal surgical procedures were performed, 75 of them open (1995–2004) and 21 laparoscopic (2004–2006). Absolute contraindications for laparoscopic surgery were solitary kidney, tumor size greater than 4 cm and location of the tumor close to the hilus. Results: There are statistically significant differences in operating time (shorter in laparoscopy), intraoperative bleeding and transfusion (greater in open surgery), and hospital stay (3.3 d in laparoscopic vs. 7.5 d in open). The positive margins are greater (not statistically significant) in laparoscopic procedure because the learning curve. Conclusion: Conservative renal surgery is a common approach for tumors less than 4 cm. The laparoscopic procedure is a difficult surgery and should be performed by surgeons with expertise in laparoscopy. The development of both laparoscopic instruments and new biological sealants allows for an easier implementation of this minimally invasive procedure.

Keywords:
Partial nephrectomy, Renal surgery, Renal laparoscopy
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© 2007 S. Karger AG, Basel
2008
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