Laparoscopic partial nephrectomy.

At the moment, OPN is considered to be the gold standard in nephron sparing surgery. LPN has become a reliable option for many patients with renal tumors up to 7 cm in many centres. Oncological data are promising and the requirements of warm ischemia time, closure of the pelvicaliceal system and hemostasis can be solved without increased risk for the patients involved. Nevertheless we believe, that safety and oncological success are essential and the surgeons ambition can sometimes be dangerous. Therefore one should not hesitate to either perform an open procedure in those cases, where tumor characteristics seem to be unfavorable for a laparoscopic approach or refer the patient to a centre with more laparoscopic experience.