Laparoscopic radical nephrectomy: morcellate or leave intact? Definitely morcellate!

Eleven years after the first laparoscopic radical nephrectomy (LRN), which was performed with morcellation, the best approach to the procedure remains controversial. Concerns include tumor seeding, recurrence, accuracy of staging, histopathological diagnosis, and longer surgery time. Enclosing the kidney in an impermeable sac prior to morcellation helps prevent seeding. Pathological review of morcellated LRN specimens has been shown to be as accurate as that of intact specimens. Ten-year survival data for LRN with morcellation are not available yet, but 5-year rates are as good as those for open nephrectomy. The utility of morcellation in LRN is supported by the results of clinical practice.