A modified mediocolic approach to removal of local relapse of renal tumour

A modified approach is recommended for removal of local relapse following leftside nephrectomy. In the course of transperitoneal mesocolic approach, the retroperitoneum is opened as usual at Treitz's ligament, between the aorta and the inferior mesenteric vein. For further exposure, two or three radial vessels are preserved. Thus, sufficient room ir available between these bridges to remove the tumour, expose the v. cava and the aorta and remove the renal vessels. Mobilization of the colon is not necessary.