Open Access

HOW I DO IT

How I do it: laparoscopic renal cryoablation (LRC)

Rodrigo Donalisio da Silva¹, Paulo Jaworski¹, Diedra Gustafson¹, Leticia Nogueira¹, Francis Kang², Wilson Molina^1,2, Fernando J. Kim^1,2,3

1 Division of Urology, Denver Health Medical Center, Denver, Colorado, USA
2 Division of Urology, Department of Surgery, University of Colorado Denver, Denver, Colorado, USA
3 University of Colorado Cancer Center Denver, Denver, Colorado, USA
Address correspondence to Dr. Fernando J. Kim, Division of Urology, Denver Health Medical Center-Urology, 777 Bannock Street, MC0206, Denver, CO 80204 USA

Canadian Journal of Urology 2014, 21(6), 7574-7577.

Abstract

Recently, diagnoses of small renal masses and renal cell carcinoma (RCC) have increased due to the widespread use of radiographic imaging studies (computerized tomography, magnetic resonance imaging). It appears that biological factors such as obesity and tobacco use increase the risk for RCC. In general, small malignant renal masses are low stage and low grade. The management of asymptomatic renal masses is a surgical challenge since overtreatment of benign masses is not desired, especially for patients with complex medical comorbidities, elderly patients, and those with impaired renal function. Partial nephrectomy has been considered the gold standard when treating small renal masses. However, technical challenges and possible irreversible ischemia-reperfusion injury should be considered when treating these lesions. Preservation of renal function without compromising oncological control is the foundation for nephron-sparing surgery. Laparoscopic renal cryoablation (LRC) emerges as an option to treat small renal masses due to the less invasive procedure with low intraoperative complications rates, with no renal ischemia-reperfusion injury and comparable medium term follow up. It is our objective to demonstrate our technique to perform an effective small renal tumor cryoablation using the laparoscopic approach.

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