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Thanks to various technical and imaging innovations, pure laparoscopic or hand-assisted laparoscopic surgery is now performed worldwide and is considered to be safe and effective, while also improving the quality of life for patients [1,2]. However, laparoscopy requires three to four incisions, each of which is about 1-2 cm long. Every incision is associated with the potential risk of bleeding, hernia, and/or damage to internal organs, and also incrementally worsens the cosmetic outcome [3,4]. Furthermore, several problems remain to be solved with regard to laparoscopy, including the use of CO2 pneumoperitoneum, the size of the incision required to retrieve the resected specimen, the need for trocar ports, and the high cost of equipment. Alternatives to conventional laparoscopy include single-site surgery, which is known as laparo-endoscopic single-site surgery (LESS), as well as natural orifice transluminal endoscopic surgery (NOTES). In 1998, Kihara et al. from Japan reported on minimum incision endoscopic surgery (MIES) performed via a single small incision, which was an attempt to solve the above-mentioned problems with conventional laparoscopic surgery and reduce technical difficulties (Figure 1) [5-9]. MIES is performed via a single small incision that is just large enough to allow extraction of the resected specimen, and is done without gas or trocar ports, making it a safe, reproducible, cost-effective, and minimally invasive treatment option [5-8]. Detection of small renal tumors has continued to increase as a result of improved imaging methods. In patients with a single, small (<4 cm), and localized renal cell carcinoma, nephron-sparing surgery (NSS) has become more common due to advances in renal imaging, improved surgical techniques, and the increasing number of incidentally discovered low-stage carcinomas. As a result, good tumor control and potentially better overall survival have been reported in patients undergoing NSS [10]. Therefore, radical nephrectomy is no longer the standard surgical procedure for such tumors and it has been

Preoperative Virtual Navigation with 3D-CT Volume Rendering for Single Minimum Incision Endoscopic Nephron-Sparing Surgery on Renal Tumors