Role of open nephron sparing surgery in the era of minimal invasive surgery

OBJECTIVE: The study aims to review the current status of nephron sparing surgery – open partial nephrectomy (OPN) for renal cell carcinoma in the minimal invasive era. The literature search was done using National Library of Medicine database (PubMed). RESULTS: Early experience with laparoscopic partial nephrectomy is promising. It has an inherent advantage of less operative time, decreased operative blood loss and a shorter hospital stay at the expense of prolonged ischemia and operative time. Complex scenarios for partial nephrectomy such as centrally located tumor, tumor in a solitary kidney, predominantly cystic tumor, and multifocal disease probably are managed best with an open technique. All these challenging situations have been addressed successfully by experienced laparoscopic surgeons, therefore these conditions are best considered relative rather than absolute contraindications for laparoscopic partial nephrectomy. CONCLUSIONS: Laparoscopic partial nephrectomy faces the problem of technical complexity and availability of expertise. Open partial nephrectomy continues to be the gold standard for nephron sparing surgery.