Does the size of the renal mass matter?
7 cm, limited to the kidney) cystic or solid renal masses. In the hands of an experienced surgeon, this can be broadened to include more extensive masses.4 Approaching large renal masses laparoscopically is a growing trend in patients with advanced disease in whom adjuvant immunotherapy is to be administered. The benefit has been earlier institution of therapy due to the shortened recovery time with the laparoscopic approach. A laparoscopic approach can also be useful in patients who may have metastatic disease. This includes patients with renal masses or evidence of disease in the regional lymph nodes. Tissue is easily obtained from either site laparoscopically, sparing the patient a large incision. Is adrenalectomy always necessary? Reviews of radical nephrectomy pathology reveal an overall adrenal metastatic rate of about 5%. With this low rate of metastatic disease, many surgeons have questioned the utility of performing an adrenalectomy in all patients undergoing radical nephrecto
