Figure 1: Left anatomical retroperitoneoscopic retroperitoneal lymph node dissection (ARRPLND). (a) Two balloon dissectors were placed through the fi rst and third skin incision and subsequently infl ated to create the retroperitoneal working space. (b) First dissection plane between the posterior peritoneum (p) and anterior renal fascia (ARF) at the superomedial side of the upper kidney pole (UPK). (c) Second dissection plane between the posterior renal fascia (PRF) and the surface of psoas muscle (PM). (d) The lymphatic tissue and fat is dissected en bloc between the anterior and posterior renal fascia (ARF and PRF, respectively). (e) The spermatic vein (SV) is exposed and clipped at its confl uence to the left renal vein (LRV). (f) Endoscopic view after ARRPLND. (g) Schematic drawings of the anatomy of fascial planes.