Introduction and objectives: Grade IV of renal trauma were the excretory tract lesions of RISe (2011). the study evaluated the role of laparoscopic management for this renal trauma lesion. Patients and methods: Prospective study of 21 grade IV renal trauma cases treated by laparoscopic surgical management at Viet Duc hospital from 6/2011 to 4/2013. Results: 15 males (71.4 percent) and 6 females (28.6 percent) with average age was 28.90 + or - 10.13 years (range from 10 to 51). Traffic accident is the main cause in 57.1 percent and shock was 38.1 percent. 42.9 percent have associated abdominal injuries combination. The finding of renal lesions on CT-Scan includes early extravasation (14.3 percent) and late extravasation (42.86 percent). Laparoscopic renal conservative surgery was 32.3 percent of total surgical indications. The successful rate of renal conservative surgery was 90.4 percent, in which evacuation of haematoma and haemostasis of renal parenchyma occupied rate of 47.6 percent, conservation renorrhaphy occupied rate of 14.3 percent, partial nephrectomy rate was 9.5 percent, decortication and capsulotomy rate was 19 percent. One conservation renorrhaphy by open conversion lombotomy for per operative haemorrhage. The rate of early complication after surgery was 19 percent. One nephrectomy by lombotomy for post operative haemorrhage. At the long-term follow-up from 2 - 20 months (mean: 14.32 + or - 7.15 months), 20 patients were observed without complication, in which 95 percent cases well recover the renal function. Conclusion: Grade IV of renal trauma were the main causes of complications in conservative treatment. laparoscopic approach is one of the first choice of surgical. Management leading to diminish the complications.
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