**3. Preoperative evaluation**

Initial evaluation is done with Ultrasonography (USG) and Contrast enhanced Computed Tomography (CECT) for the exact site, size of renal cell carcinoma, extension beyond Gerota's fascia, liver secondaries, Inferior Vena cava (IVC) involvement and hilar lymphadenopathy. Routine blood investigations – complete blood counts, liver function tests and renal function tests is necessary to assess the contralateral renal function and fitness for surgery. X ray or CT of the chest is required for the assessment of pulmonary metastasis. A bone scan is done for patients with elevated serum calcium or alkaline phosphatase levels and in those with symptomatic bone pain. If renal vein/IVC tumor thrombus is suspected, it needs appropriate evaluation by Magnetic Resonance Imaging (MRI), or threedimensional CT preoperatively [6].
