Although they are rarely associated with complaints, benign renal cysts may be the cause of pain, hypertension, or other problems. Simple aspiration is rarely definitive treatment. We have had good results with three laparoscopic approaches to cyst unroofing: transperitoneal, with reflection of the colon medially or dissection through the mesocolon and direct retroperitoneoscopy. We recommend initial percutaneous aspiration with cytology study both to rule out malignancy and to identify those cysts clearly in need of unroofing.
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