Laparoscopic radical nephrectomy is advantage superior to opened surgery in regard to perioperative morbidity, postoperative pain, time of hospitalization and convalescence. The location and size of surgical specimen extraction wound is correlated with cosmetic, pain and convalescence because of big size of incision and some location can cause of pain by cutting and retraction of wound during removed specimen. However, most studies concern tumors smaller than 7 cm and the role of laparoscopy for large primary tumors is not clearly established. The purpose of the study is to present the operative
technique and to discuss several unique problems that arise during the laparoscopic procedure in patients with large renal masses by small specimen extraction wound.

Keywords: Kidney, Large renal tumor, Radical nephrectomy, Laparoscopy