Introduction: Compared to traditional open radical nephrectomy, the laparoscopic approach has been proven to have several benefits such as decreased blood loss, less postoperative narcotic requirements, and shorter hospital stay and duration of convalescence. Aim: Laparoscopic radical nephrectomy for clinical stage T1 and T2 tumors which are greater than 7 cm. Materials and methods: It is retrospective study done between September 2016 and august 2019 were retrospectively reviewed. Laparoscopic Radical Nephrectomy was performed in 87 patients with tumors 7 cm or greater. Results: Out of 87 patients were analysed 47 (54%) patients were men, tumour size was 5.6 ± 2.3 cm, and the right kidney was involved in 50 (57%) patients. Transperitoneal approach was employed in 64 (73%) procedures. Mean operative time is 170 minutes, blood loss 110 ml and intra operative complications were 10 cases (8.7%) with one cases needed open surgery (1.1%). Postoperatively patient has 7 days of hospital stay with post OP complications in 20 cases (17.4%) and median week of convalescence is 4 weeks. RCC was confirmed in 69 (79%) of the patients, Pathological tumor stage was most of the patients are in pT1 and pT2. Total intraoperative complications in study are 10 cases (11.5%) with vascular/Haemorrhage in most of the cases (6.9%). Post-operative complications were in 13 cases (15%) most of the complications are with wound (4.6%). in operative time and complications which is slightly more in trans peritoneal approach which is significant (p < 0.05). Conclusions: LRN for renal tumours which are larger (greater than 7 cm) is efficacious. Decreased blood loss, lesser complications and shorter hospital stay are the advantages observed.

Keywords: Laproscopic Radical Nephrectomy; Large Renal Tumors; Transperitoneal approach