TECHNIQUE

Laparoscopic Technique. In a laparoscopic ablation, the tumor can be directly visualized, and the ablation process can be monitored in real time.

The tumor can be accessed from either a transperitoneal or retroperitoneal approach, depending on its location. In the transperitoneal approach, the colon is mobilized medially to expose the renal fascia, which is mobilized from its attachments to surrounding structures, such as the liver or spleen. Next, the renal fascia is entered over the area of the renal mass, which is targeted using preoperative imaging and intraoperative ultrasound. The perirenal fat is then carefully removed from the renal capsule to expose the entire surface of the tumor.