Retroperitoneoscopic partial nephrectomy

3. Starting surgery

Forced lateral decubitus. In retroperitoneal access (Figure 12), a forced lateral decubitus is required in order to increase the distance 12th rib and iliac crest. The back of the patient must be on the edge of the surgical table. Preparation is completed with compression stockings in the lower limbs with a progressive pneumatic compression device, bladder

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2. Renal Retroperitoneal OR

Basic equipment for renal retropernitoneoscopic surgery: Specific equipment: Gaur’s balloon (comercial or home-made) for dissection of retroperitoneal space. Hasson’s trocar. Consumable material; tourniquet for kidney artery control, sutures for kidney parenchyma. Conventional laparoscopic equipment: Videolaparoscopic tower High flow insufflator Surgical instruments Generators for dissection and haemostasis. Aspirator/irrigator Trocars Figure 5. OR’s distribution for a right

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1. Introduction

Indications Retroperitoneoscopic approach allows direct access to the kidney to perform a nephron-sparing surgery. We will choose this approach in selected cases; either because lesion’s location (figure 1) or because the patient had with multiple abdominal surgeries or has catastrophic abdomen, in which transperitoneal access is not recommended or impossible (Figure 2). LOCALIZATION OF THE

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