Murali K Ankem

Department of Urology, Louisiana State University Health Sciences Center, and Overton Brooks VA Medical Center, Shreveport, Louisiana, U.S.A. Stephen Y. Nakada

Division of Urology, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.

INTRODUCTION

PATIENT SELECTION: INDICATIONS AND

CONTRAINDICATIONS

PREOPERATIVE PREPARATION

TECHNIQUE

Operating Room Setup

Patient Positioning

Trocar Placement

■ INSTRUMENT LIST

■ TECHNICAL CAVEATS AND TIPS

■ REFERENCES

The American Cancer Society estimated the incidence of new renal cancer cases and deaths for the year 2004 at 22,080 and 7870, respectively.

Nephron-sparing surgery has emerged as a preferred option in the treatment of most renal tumors less than 4 cm in patients with an existing or potential compromise of renal function and in select tumors with a normal contralateral kidney. Long-term cancer control and renal function after partial nephrectomy has been reported as being similar to radical nephrectomy.

The benefits of nephron sparing minimally invasive therapies include maximal renal sparing, decreased morbidity, decreased hospital stay, and shorter recovery.

Cryoablation is the destruction of cells by consecutive rapid freeze and thaw cycles leading to complete and reproducible necrosis of renal parenchyma occurring at temperatures of -19.4°C or less.

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