The first laparoscopic nephrectomy was performed by dr R. Clayman in St. Louis USA in 1990 for a non cancerous kidney. Since the laparoscopic nephrectomy is becoming a reference in kidney surgery for begnin or malignant tumors.

Under general anesthesia, the retroperitoneal space is insufflated and a 10mm ....umbilicus.

Five trocars are placed in the abdominal wound allowing an optimal vision and manipulation of the kidney.

The optic is voice telecommanded.

The kidney is dissected above the colon and the renal artery and vein are ligated and transsected.

The ureter is clipped and the adrenal is removed when the tumor exposes to a high risk of invasion or metastasis (exceptional).

At the end, the kidney is entrapped in a special bag and extracted from the abdomen through a small incision .

A small drain is left in place for 1 or 2 days.

Conversion rate in open surgery : 6% of cases (obese patients or very big tumors) .

The cost of surgery : 70.000 french francs (including fees, room, operating room and intensive care unit, drugs, biological exams and radios). It is a forfait independant of the number of hospitalisation days.