During the past 4 years, 16 patients with testicular tumor underwent retroperitoneal lymph node dissection using the thoracoabdominal extraperitoneal approach described by Scardino. In 4 of them, the lymph node dissection was performed without pleurotomy using our modified technique. No uncontrollable intra- or post-complications or operative deaths occurred in our series. From our experience, it was concluded that the thoracoabdominal approach was suitable for maximum exposure of the retroperitoneal area and was associated with lower mobility. Furthermore, our modified extrapleural extraperitoneal technique also provided an excellent operative field comparable to the thoracoabdominal approach.