Laparoscopic Nephrectomy: Initial Case Report

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Presentation transcript:

Laparoscopic Nephrectomy: Initial Case Report Ralph V. Clayman, Louis R. Kavoussi, Nathaniel J. Soper, Stephen M. Dierks, Shimon Meretyk, Michael D. Darcy, Frederick D. Roemer, Edward D. Pingleton, Paul G. Thomson, Stephenie R. Long The Journal of Urology Volume 197, Issue 2, Pages S182-S186 (February 2017) DOI: 10.1016/j.juro.2016.10.074 Copyright © 1991 American Urological Association, Inc. Terms and Conditions

Fig. 1 Preoperative CT scan reveals 3 cm. renal mass (arrows) occupying lateral border of mid portion of right kidney. Right kidney measures 6.5 x 8.5 x 6.5 cm. The Journal of Urology 2017 197, S182-S186DOI: (10.1016/j.juro.2016.10.074) Copyright © 1991 American Urological Association, Inc. Terms and Conditions

Fig. 2 Preoperative angiogram reveals single renal artery with 5 segmental branches (small arrows) supplying kidney and vascularized renal mass (large arrows). The Journal of Urology 2017 197, S182-S186DOI: (10.1016/j.juro.2016.10.074) Copyright © 1991 American Urological Association, Inc. Terms and Conditions

Fig. 3 A, intraoperative view of kidney completely freed from its retroperitoneal attachments and vascular supply. Kidney is suspended from renal hilus via 5 mm. grasper passed through 1 abdominal sheath. B, intraoperative view of kidney placed into nylon surgical sack. The Journal of Urology 2017 197, S182-S186DOI: (10.1016/j.juro.2016.10.074) Copyright © 1991 American Urological Association, Inc. Terms and Conditions

Fig. 4 Gross specimen of right kidney. Specimen weighed 190 gm. Renal parenchyma is to left side and suspected fragments of tumor are on right side. The Journal of Urology 2017 197, S182-S186DOI: (10.1016/j.juro.2016.10.074) Copyright © 1991 American Urological Association, Inc. Terms and Conditions

Fig. 5 On postoperative day 2 CT scan at level of lower pole of left kidney (arrow) reveals absence of right kidney and minimal amount of intraperitoneal fluid. Abdominal wall on right side is mildly thickened. The Journal of Urology 2017 197, S182-S186DOI: (10.1016/j.juro.2016.10.074) Copyright © 1991 American Urological Association, Inc. Terms and Conditions

Fig. 6 Abdomen 10 days after laparoscopic nephrectomy. Long arrow denotes umbilicus. Closed arrows show 5 mm. trocar site. Open arrows show 11 mm. trocar sites. The Journal of Urology 2017 197, S182-S186DOI: (10.1016/j.juro.2016.10.074) Copyright © 1991 American Urological Association, Inc. Terms and Conditions