DEFINITION
Also
Nephrolithoto
my
Benign Renal
Lesions
Nephrectomy,
Drainage of
abscess, etc
INDICATION
Proximal
ureterolithoto
my
Surgery of
upper
urologic tract
Pyelolithotom
y
Pyeloplasty,
etc
ANATOMY
EQUIPMENT
Sterile gawn, gloves,
cap and mask
Sterile drap
Sterile gauze
Povidone iodine
Disinfection clamp /
ring clamp
Towel clamp
Sharp spreader
Langenback
Kocher clamp
Suction device
Mosquito clamp
Scissors
Metzenbaum
Neddle holder
Rectangle
Forceps
Millins retractor
Drain
Plain catgut
Polyglicolic acid
Polypropylene
SURGICAL TECHNIQUE
After
general
anaesthesia, place
the patient in the
full flank position
with the table
flexed. (Hinman Atlas of
Urologic Surgery, 2012)
Umbilicus
Rib XII
Separate the
peritoneum toward
medial side.
After the
peritoneum is
loose, the incision
is widened in
accordance with
the incision on top.
Attach spreader
WOUND CLOSURE
Partially straighten
the table, just
enough to allow the
edges of the wound
to come together
but not enough to
impede the insertion
of sutures.
Insert a suction
drain to exit through
a stab wound.
WOUND CLOSURE
Start anteriorly to
close the muscles
interuptedly using
3/0 PGA material.
Close the fascia
intureptedly using
2/0 PGA material.
Subcutaneous fat is
closed using 3/0
plain catgut.
Close the skin by 3/0
polypropylene.
Earl
y
Late
Infection
Fistule
Haematuri
a
Hernia
Leakage of
urine
thank you