A dorsal lumbotomy incision can be used when retroperitoneal access to the kidney is desired in patients who have fibrosis associated with prior abdominal or flank incisions. The incision is…
After surgical revascularization, complications include persistent stenosis, graft thrombosis, and restenosis of the repaired lesion. Mortality rates are very low among patients with FMD, owing to their young age and…
COMPLICATIONS The complications associated with nephrectomy include standard surgical complications, such as bleeding, infection, wound separation, myocardial infarction, cerebral vascular accident, deep vein thrombosis, pulmonary embolus, cardiac dysrhythmia, ileus, and…
A midline transperitoneal incision may be used for patients undergoing exploratory laparotomy for trauma, during which an indication for nephrectomy may be discovered. It is not a common incision in…
ENDOPYELOTOMY An endopyelotomy begins with direct visualization of the obstruction from either from a retrograde approach (ureteroscopy, see page 10-33) or anterograde approach (nephroscopy, see Plates 10-13 and 10-14). A…
Endovascular revascularization consists of percutaneous dilation of the renal artery (often termed percutaneous transluminal angioplasty, or PTA). The femoral or radial artery is catheterized using the classic or modified Seldinger…
In the past, tract dilation was accomplished using either metallic telescoping dilators (the Alken system) or Teflon-coated graduated dilators (the Amplatz system). At present, however, most centers use balloon-dilating systems….
COMPLICATIONS The major complications associated with PCNL are hemorrhagic. Occasionally, PCNL procedures need to be aborted before complete stone ablation if bleeding prohibits adequate stone visualization. Bleeding is most commonly…
PROCEDURE Most patients are positioned supine on the lithotripter bed; however, those with stones in anteriorly located kidneys, medial portions of a horseshoe kidney, or transplanted kidneys should be positioned…
Continuous veno-venous hemodialysis (CVVHD)—CVVHD is similar to hemodialysis as described earlier but is continuous rather than episodic. This modality consists primarily of diffusive clearance of small molecules. Some convective clearance…
