ttelo1.gif (1393 bytes) LAPAROSCOPY  IN  UROLOGY

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SIMPLE NEPHRECTOMY - Page 1 of 2


The first laparoscopic simple Nephrectomy was done by Clayman in USA in 1990. Since then, many large series have been published showing the many real advantages this technique has over open Nephrectomy.

Chief of these are - shorter hospital stay and post surgical recovery period and the remarkably painfree post operative period in comparison to open surgery. The surgical complications are less when compared to open surgery. The main disadvantage is the steep learning curve for the technique.

Case of RETROPERITONEOSCOPIC SIMPLE NEPHRECTOMY - Rt. Side

Position of the patient
The patient is placed in the standard lateral position as for open Nephrectomy.

Port placement -
Finger dissection of retroperitoneum(9709 bytes)3 or 4 ports are usually placed. The first port is placed below the tip of the 12th rib in the posterior axillary line. A 2 cm incision is placed down to the retroperitoneal space. The space is enlarged with a finger, pushing the peritoneum anteriorly.

 

Dialatation balloon(13625 bytes)Balloon in retroperitoneum(11290 bytes)A dilatation balloon prepared by tying a glove finger over a rubber tube, is placed in the reteroperitoneal space and distended to about 600 ml with  saline.

 

ports in postion (15874 bytes)Four ports were then used. 2 were on the posterior axillary line and 2 on the aneroir axillary line, above and below the level of the umbilicus.

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