Patient indication, instruments and trocar placement F. Porpiglia

Step 1: Indications, instruments and trocar placement

• Indications for the procedure include cases of T1 renal masses with a PADUA score lower than 9 and posterior localization of the tumor.
• Contraindications include anteriorly located renal masses, obese patients and patients with prior history of significant retroperitoneal surgery.
• Instruments with a diameter of 3mm and trocars with a 3.9mm diameter are used.
• 4 ports are placed in a diamond shape.
• The camera port  (12mm) is inserted next to the iliac spina on the mid axilliary line. 
• Two 3mm ports are placed at the level of the umbilicus on the anterior and posterior axilliary lines.
• One port is inserted at the tip of the 12th rib.