Introduction: This video illustrates the key aspects of laparoscopic approach of a giant retroperitoneal cyst. We present the case of a 51-year-old woman who was admitted due to heaviness and abdominal pain located in the right upper quadrant. The examination revealed a mass of the right hemi-abdomen. An ultrasound and MRI were performed showing a retroperitoneal peritoneal cyst of about 30 by 25 centimeters.

Methods: The surgery was initiated by the section of the parietal peritoneum and dissection of the entire right lateral face until reaching the subhepatic space. The dissection continues by dividing the lesion from the anterior aspect of the kidney. Then proceed through the inner side of the cyst to descend the entire right colon. From the lower face we proceed to release it from the retro peritoneum. We then free the cyst from Gerota's peri renal fat. Finally, release of the lesion of the posterior face of the kidney to finally complete the excesion and extraction by one of the trocars extending 3 centimeters the incision.

Results: The patient tolerated well the procedure. She was discharged home on postoperative day 2 uneventfully.

Conclusion: The experience of the laparoscopic approach of retroperitoneal tumors is very small, and most citations have used the pure extra peritoneal route or transperitoneal, so there are still unknowns that should be cleared. We conclude that laparoscopic approach for this disease is safe and feasible and should be the first treatment option.