OBJECTIVE: This work is reported toencourage experienced urologists to take advantage of alaparoscopic nephrectomy technique that has evolvedinto a remarkably inexpensive, uncomplicated routineprocedure almost comparable with the gallbladderoperations of general surgery.METHODS: The patient is placed in the lumbotomyposition. The unsleeved, uncuffed hand is introducedthrough a mini-McBurney incision in the iliac fossa. Thefirst 12 mm trocar is introduced just above the posteriorpart of the iliac crest. The second is placed anteriorly some10 to 12 cm from the first. The kidney is released byextraperitoneal manual dissection. The artery is clippedand sectioned and then, without dissecting the vein, therest of the pedicle is sectioned en bloc with the endostapler.However, if the artery is not found, then the whole pedicleis sectioned en bloc. Lastly, the ureter is sectioned. Thekidney is then introduced into a simple plastic bag (openurine bag) and digitally fragmented for easy removalthrough the incision.RESULTS / CONCLUSIONS: The oblique McBurneyincision is also useful in the event reconversion to an openlumbotomy is necessary. As we described in 1994, manual manipulation significantly simplifies the procedure.Operators soon gain confidence when they appreciate inpractice the surprising versatility of the technique. Becausemost of the procedure is done under visual control,operator precision soon increases and successive operationtimes shorten considerably. Operation costs are lowerbecause an expensive inflatable cuff or sleeve isunnecessary, only two trocars are required and a standardurine bag serves to receive the kidney. We are sure thatonce urologists experienced in conventional surgery trythe procedure, they will wonder why they did not adopt itearlier.