Technique Of Anatomical Retroperitoneoscopic Radical Nephrectomy

0bjectiveTo introduce the technique and clinical effect of anatomical retroperitoneoscopic radical nephrectomy.MethodsA total of 168 patients underwent anatomical retroperitoneoscopic radical nephrectomy. The tumor were 4.7cm(range,2.0-6.9cm)in diameter,with 87 tumors in the left renal,81 in the right renal.Preoperatively,92 cases had tumors of clinical stage TlaN0M0,76 of T1bN0M0.Retroperitoneal space was created routinely at lateral decubitus position.After retroperitoneal space,four relatively bloodless planes were orderly entered for exposure and separation of the kidney outside Gerota's fascia. The first dissection plane is between the psoas and posterior Gerota's fascia , The following dissections proceeded in the bottom of Gerota's fascia. The third dissection plane is between the adrenal gland and upper pole of kidney or between the adrenal gland and diaphragma .The fourth dissection plane is in the plane between posterior Gerota's fascia and fusion fascia .ResultsA1l operations succeeded .The mean operative time and estimated blood loss were(138±46) min and (90±30)ml. Average days to oral intake and ambulation were 1.3 and 1.2,The mean postoperative hospital stay was 5.8 days .Peritoneum injury in 14 patients, 18 patients had omalgia , the omalgia disappeared after 2 days. 123 patients were followed up,they survived during the follow-up of 8 months on average(range,6-18 months.ConclusionsAnatomical retroperitoneoscopic radical nephrectomy is a safe and effective procedure , It can decrease operation time and blood loss effectively , and can decrease the rate of complication remarkably.A better choice is Provided for the patient whom demand radical nephrectomy.