Transperitoneal Izquierda

9. Marking the tumor margins

Once the healthy parenchyma has been exposed around the tumor we proceed to mark the margins for excision. Partial nephrectomy should be oncologically safe. This means that the tumor comes out surrounded by a margin of healthy tissue. Traditionally this margin was 5 mm, although different studies have shown that it may be smaller, minimal, […]

9. Marking the tumor margins Read More »

6. Renal pedicle dissection

The OBJECTIVES of the left renal pedicle dissection include: Identification and dissection of the renal vein and its branches: gonadal, lumbar and adrenal veins Identification of the renal artery behind the renal vein, near its exit from the aorta To achieve enough dissection of the vessels to have vascular control and be able to perform clamping safely.

6. Renal pedicle dissection Read More »

5. Access to the retroperitoneum: peritoneal opening and colon mobilization

The objectives of this phase are: To open the parietal peritoneum, following the line of Toldt, from the iliac fossa up above the spleen To mobilize the descending colon and its mesentery following the avascular plane To identify retroperitoneal references:  gonadal vein, ureter and psoas muscle. Errors we should avoid include: To open through the mesocolon.

5. Access to the retroperitoneum: peritoneal opening and colon mobilization Read More »

3. Trocar placement

For left partial nephrectomy we generally use 4 trocars on a diamond shape (Figure  3.1): Pararectal Hasson´s trocar Left iliac fossa 12 mm trocar. Subcostal 5 or 11 mm Trocar. Lateral 5 mm trocar on the mid-axillary line Figure 3.1: Trocar insertion This preferred trocar disposition admits great variations for partial nephrectomy depending of each

3. Trocar placement Read More »

Scroll to Top