OBJECTIVES: We present our 11 yearexperience with 15 laparoscopic nephroureterectomyprocedures for upper urinary tract urothelial tumor.METHODS/RESULTS: The tumor site was pyelocalyceal in9 cases, ureteral in 4, and multifocal in one. All caseswere urothelial tumors grade II or III; stage was Ta-T1 in9 cases,T2 in three, T3 in two, and T4 in one.Transperitoneal approach was performed in 14 cases,whereas only one retroperitoneal. Hand assisted laparoscopywas performed in five cases. Seven specimens wereextracted after morcellation without any recorded tumorseeding attributable to this manoeuvre.We recorded one case of sudden death due to pulmonaryembolism 48 hours after the procedure, one case ofintestinal obstruction secondary to an ileal loop herniathrough the parietal orifice of one of the trocars, andone case of unstable angina pectoris. Two patients diedbecause of disease progression, one of them after bladderrecurrence.CONCLUSIONS: We think that hand assisted laparoscopyis a good indication for nephroureterectomy for upperurinary tract urothelial tumor.We propose a new procedure to avoid possible tumorcell spilling at the time of ureterectomy, which simplifiesthe operation very much at the same time.