Patients with small renal lesions are suitable for laparoscopic nephrectomy. However, patients with large tumours especially those greater than 10 cm, are often deemed unsuitable for a laparoscopic approach. For a right sided tumour greater than 10cm that is confined to the kidney, our preference is for a thoraco-abdominal incision. We present a case report of a man who successfully underwent laparoscopic nephrectomy for a 115x105x85mm right mid pole renal tumour who had previously undergone a bilateral pleurodesis; thus making a thoraco-abdominal incision inappropriate. This report demonstrates the safety of a laparoscopic approach and challenges the tenant that size is a contra-indication to laparoscopic nephrectomy.
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A 2011 study studied this question.