Fig. 1

Intraoperative showing: incision of the renal parenchyma near the tumor edge until the tumor pseudocapsule is identified or the bleeding is interfering with the safe removal of the tumor (A). The renal artery is blocked by an inflating balloon, and cold ischemia is achieved by perfusion of chilled Ringers until the renal parenchyma becomes bleached (B). Removing the tumor with blunt dissection by using the natural cleavage plane between the tumor and normal parenchyma (C–E). The renal surface is examined to rule out tumor infiltration and hemorrhage in the tumor bed is controlled by bipolar coagulation without sutures conventionally (F). The single-layer renorrhaphy technique is performed for renal reconstruction (G). Deflating the balloon and inspecting the parenchymal defect (H)