Despite the rising popularity of the minimally invasive laparoscopic option, open nephron-sparing surgery is still seen by many experts as the 'gold standard' for open surgery for kidney tumors and should remain the first choice for many patients. This challenges the idea that less-invasive therapies are always more desirable than open surgery. While laparoscopic nephron-sparing surgery may be a more attractive option for treating small, easily accessible kidney tumors, for large tumors this is not always the case.