Fig. 5.1
(a, b) Equipment and patient position during right and left nephrectomy/adrenalectomy
Surgical Steps in Nephrectomy
1.
Landmark recognition
2.
Colon mobilization
3.
Renal vein isolation
4.
Renal artery isolation and section
5.
Renal vein section
6.
Ureter and gonadic vessels
7.
Nephrectomy (adrenalectomy if needed)
Surgical Steps (Left Adrenal Gland)
1.
Landmark recognition
2.
Colon mobilization
3.
Splenopancreatic mobilization
4.
Renal vein isolation
5.
Adrenal vein isolation and section
6.
Left adrenalectomy
Surgical Steps (Right Adrenal Gland)
1.
Landmark recognition
2.
Colon mobilization
3.
Caval vein exposition
4.
Adrenal vein isolation and section
5.
Right adrenalectomy
5.2 Equipment in Nephrectomy and Adrenalectomy
Instruments and Cables
Specific surgical drapes are used.
30 and 5/10 mm laparoscope
Cold light source cable
CO2 pipe and filter
Monopolar electrocautery
Patient return electrode (REM)
Two sterile instrument bags
Bipolar laparotomic forceps
Monopolar and bipolar electrocautery cables
Ultrasonic dissector or radiofrequency cables
Irrigation/suction laparoscopic device
Bladder catheterization set
Peridural analgesic catheter and specific set
Fig. 5.2
Instrument table
Laparoscopic Instrument Table (Fig. 5.2)
Sutures: 2-0 absorbable braided suture, 5-0 monofilament not absorbable, one suture with vascular needle, one braided absorbable suture, and one skin wound closure sutures
Surgical scalpel blade No. 23
Gauzes
Laparoscopic gauzes
Stainless surgical bowl
Gross-Maier dressing forceps
Two Bernhard towel forcepsRelated posts:
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