To the Editor: Laparoscopic radical nephrectomy (LRN) is the standard of care for patients with T2 tumors and localized masses not treatable by partial nephrectomy according to the European Association of Urology Guidelines on renal cell carcinoma.[1] Transperitoneal and retroperitoneal are two main approaches in LRN. With the advantages of easier hilar control, shorter operation time, and less bowel irritation, retroperitoneal approach is preferable in our center. The peritoneal tear is a common intraoperative complication during retroperitoneoscopic procedures, leading to the collapse of the retroperitoneal space. Currently, there is no solid evidence to support the routine closure of peritoneal tears. On the contrary, many surgeons believe that unless subsequent procedures are severely disrupted, peritoneal tears could be left open because they would rapidly be reperitonealized.[2] According to our daily practice, most peritoneal tears require no repairment. However, a rare case of internal hernia (IH) after retroperitoneal LRN raised our concern about this issue.
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