Hand-assisted laparoscopic resection of the massive autosomal dominant polycystic kidney.

Laparoscopic nephrectomy provides many advantages over open nephrectomy, including pain reduction, hospitalization, and superior cosmesis. However, the bulkiness of massively enlarged polycystic kidneys may preclude access to the renal hilum and therefore prevent safe ligation and division of the renal vascular supply. We describe a hand-assisted technique that facilitates the resection of the massively enlarged kidney.