Indications And Contraindications

The indications for laparoscopic partial nephrectomy have been expanded beyond small, exophytic, and peripheral renal tumors to include patients with more involved tumors placed deep in the kidney, abutting the collecting system or renal sinus, completely intraparenchymal, adjacent to the renal hilum, or tumor in a solitary kidney. Laparoscopic partial nephrectomy for such complex tumors is performed only when nephron sparing surgery is indicated. Contraindications for laparoscopic partial nephrec-tomy include renal vein thrombus, multiple (>2) renal tumors, uncorrectable bleeding diathesis, and a history of prior ipsilateral renal surgery. Relative contraindications for laparoscopic partial nephrectomy include morbid obesity and baseline azotemia (3).

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