Surgery 3: Left Transperitoneal Laparoscopic Partial Nephrectomy
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Surgery 3: Left Transperitoneal Laparoscopic Partial Nephrectomy Read More »
Once renorraphy is complete we try to close Gerota´s and peritoneum. The closure of the Gerota’s fascia has a triple objective: First, to return the kidney to its original retroperitoneal position Second, to cover of the surgical bed with the perirenal fat layer, which can contribute to hemostasis. Third, to fix the kidney, which we mobilized
14. Specimen bagging Read More »
Once renorraphy is complete we try to close Gerota´s and peritoneum. The closure of the Gerota’s fascia has a triple objective: First, to return the kidney to its original retroperitoneal position Second, to cover of the surgical bed with the perirenal fat layer, which can contribute to hemostasis. Third, to fix the kidney, which we mobilized
13. Closure of Gerota’s fascia and nephropexy Read More »
The suture repair of the kidney is performed in two planes. First, the deep suture of the surgical bed. It has two objectives: Closure of the urinary tract and Hemostasis. Control of the main vessels. It is usually performed under ischemia, so we add the pressure of ischemia time to the difficulties of the suture.
The objectives of tumor excision are: to remove the tumor maintaining a margin of healthy tissue around, and to preserve the maximum healthy kidney. The main risk of tumor excision is to enter the tumor causing a surgical margin. Another, less important risk is removing too much healthy tissue. Previous considerations. We place the kidney in the optimal
11. Tumor excision Read More »
Pedicle clamping is a very important phase of partial nephrectomy. By clamping we eliminate blood flow to the kidney, completely or partially, so we can perform tumor excision and renorraphy with good control, avoiding excessive bleeding. The variety of scenarios we face during partial nephrectomy is important. We can perform from off-clamping enucleation of a
10. Renal pedicle clamping Read More »
We place the patient on right side decubitus (lumbotomy position) with lumbar lift (roller) and the table flexed. It is important to protect the pressure areas and place an axillary roll to avoid brachial plexus injuries. The right arm lies on an armrest and the left on a stirrup above, to avoid instrument clashing during
1. Patient positioning and operating room disposition Read More »