Laparoscopic nephrectomy

To the Editor: In their letter of May 9, Clayman et al.* report the first laparoscopic nephrectomy. They state that a minimally invasive approach was justifiable because the patient was elderly. Their procedure had an operative time of seven hours and required a 1-unit transfusion and a six-day inpatient hospital stay. In addition, the patient was subjected to possible tumor dissemination. A traditional nephrectomy would probably have had less morbidity. The advanced age of a patient should not be used as an excuse to substitute a glamorous experimental procedure when there is a safe, acceptable, tried and true alternative.