Laparoscopic partial nephrectomy: advances since 2005

Abstract

Purpose of review: Laparoscopic partial nephrectomy (LPN) technique has continually evolved over the last decade, resulting in better outcomes and increased popularity within the urological community. In this article, we provide an overview of the contemporary literature on LPN.

Recent findings: The technique of LPN has evolved over the last 5 years with a nearly 50% reduction of warm ischemia time in experienced hands. Complication rates have also declined such that morbidity and oncological outcomes are comparable to open partial nephrectomy, the gold standard. LPN is now an established procedure for the treatment of T1a renal tumors. It can also be safely performed for favorably located T1b tumors and more complex tumors, including hilar tumors, central tumors or tumors in solitary kidneys with good oncological and functional outcomes.

Summary: For renal tumors less than 4-7 cm (T1 lesions), partial nephrectomy is the treatment of choice. Contemporary LPN is a sophisticated procedure, and in expert hands, offers perioperative, functional and oncologic outcomes comparable to open partial nephrectomy, even for complex tumors.