[History of nephrectomy].
Following animal experiments (Combair 1803, Prevost and Dumas 1823) and accidental removal of the kidney in humans (Spillgellberg 1867, Peaslee 1868, Wolcott 1886), it has been established that elimination of a single kidney does not lead mandatorily to fatal outcome if the second functioning kidney is preserved. The chronology of nephrectomy development on a worldwide scale, and in Bulgaria as well, after the first routinely scheduled nephrectomy performed by Gustav Simon (2 Aug 1869), is presented. In 1897, almost 30 years later, Ivan Mikhaylovsky from the Plovdiv Hospital performed the first nephrectomy in this country. In the late 19th and early 20th century, nephrectomy becomes one of the most often used kidney operations (H Kumill, 1913--49.3 per cent), but gradually parallel to improving the diagnostic technique it is less frequently applied (W Lutzer et al, 1976--28 per cent) at the expense of organ-salvaging interventions. The last decade marks the introduction of laparoscopic nephrectomy (RV Clayman et al, 1991, AD Joce et al, 1992, JJ Rassweller et al, 1993, Sy Nakada et al, 1996, CC Abbou et al, 1998) which is a safe procedure even in patients with malignant renal pathology and adequately selected cases presenting various urological diseases.