"Polar flip" technique for transperitoneal laparoscopic partial nephrectomy - Evolution of a novel technique for posterior hilar tumors

Posterior hilar renal tumor extirpation by partial nephrectomy is a unique challenge for transperitoneal laparoscopy. We describe our novel technique of "polar flip" for these tumors. Kidney is rotated by around 45 -60 degrees after mobilisation so that lower pole faces anteriorly and uppe...

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Bibliographic Details
Published in:Indian journal of urology 2019-07, Vol.35 (3), p.230-231
Main Authors: Chiruvella, Mallikarjuna, Ghouse, Syed, Tamhankar, Ashwin
Format: Article
Language:English
Subjects:
Aircraft
Dissection
Laparoscopy
Methods
Surgery
Tumors
Video
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Summary:Posterior hilar renal tumor extirpation by partial nephrectomy is a unique challenge for transperitoneal laparoscopy. We describe our novel technique of "polar flip" for these tumors. Kidney is rotated by around 45 -60 degrees after mobilisation so that lower pole faces anteriorly and upper pole faces posteriorly, thereby exposing the posterior surface for maneuverability. Technical highlights are hilar control, complete kidney mobilisation, initial flipping with dissection in Gil Vernet's plane to clip posterior segmental renal artery, en mass hilar clamping in normal lie, polar flipping, dissection in Gil Vernet's plane till renal sinus fat, completion of tumor excision, selective vascular ligation, renorhaphy and nephropexy.
ISSN:0970-1591
1998-3824
DOI:10.4103/iju.IJU_235_18