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[Endoscopy-assisted renovascular surgery]
E Sánchez de Badajoz1, J Gómez de la Cruz, A Jiménez Garrido
1Departamento de Cirugía del Hospital Materno Infantil, Málaga, España.
Objectives:
Laparoscopic surgery still has many impediments which render it impracticable or very difficult in many cases. In this article we describe in the laboratory the possibilities of performing it helped with a hand that has previously been introduced in the abdomen through a minilaparotomy.
Methods:
Once the animal is in the lateral decubitus position, a longitudinal suprapubic incision of some 5 cm is done, through which the surgeons left hand is introduced. Then, together with the instruments, the kidney, its vessels, the aorta and vena cava are dissected. In one case the left renal artery was temporally clamped, divided and then sutured.
Results:
This minimally invasive technique allowed in all the cases to accurately perform the operation in a very short time and with minimal risk.
Conclusions:
The main indication of this technique are the cases in which a large incision is required, as in large renal tumors or testicular cancer surgery. It is particularly useful in previously operated patients, or if a complication arises during a laparoscopy, or if a minilaparotomy is required as, in ileal conduits. This procedure also opens the door to a new approach to renovascular surgery.