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Способ лапароскопической билатеральной нефрэктомии при аутосомно-доминантной поликистозной болезни почек
专利权人:
Biktimirov Rafael Gabbasovich
发明人:
Biktimirov Rafael Gabbasovich,Биктимиров Рафаэль Габбасович,Martov Aleksej Georgievich,Мартов Алексей Георгиевич,Biktimirov Timur Rafaelevich,Биктимиров Тимур Рафаэлевич
申请号:
RU2017106618
公开号:
RU0002664175C1
申请日:
2017.02.28
申请国别(地区):
RU
年份:
2018
代理人:
摘要:
FIELD: medicine.SUBSTANCE: invention relates to surgery and may be useful for laparoscopic bilateral nephrectomy in autosomal dominant polycystic kidney disease. Periomphalicaly 10 mm optical trocar, as well as 10 mm instrumental trocars in the left ileal region and epigastrium on the left, as well as a 5 mm trocar in the lumbar region to the left. Access is made to the left kidney, during which the peritoneum is opened through the avascular zone – the Told lines with mobilization of the left curvature of the colon, the medial descending part of the colon is extracted and displaced. Isolate the anterior surface of the left kidney within the paranephric fascia, visualize and secrete the renal vein, clip its inflows – the central vein of the left adrenal and gonadal vein. Isolate the aorta in the zone of her anastomosis with the renal artery. Isolate the renal artery, clip with two clips with a lock and intersect with an indent from the proximal clip for 2–3 mm. Isolate and clamp the left renal vein with three clips with a lock, two of which are imposed on the proximal end of the vein and one – on the removed renal end. Dissect the renal vein between the clips with the preservation of the stump 2–3 mm with an indentation from the clips remaining on the vein. Isolate with the use of bipolar coagulation left kidney from surrounding tissues with preservation of the left adrenal gland. Clamp and dissect the left ureter in its upper third for further use in reconstructive interventions. Aspirate the fluid contents of the left kidney cysts with a decrease in its volume. Operating zone is irrigated with an aqueous solution of iodine followed by aspiration. Visualization and allocation of the aortic anterior surface to the level of the superior mesenteric artery and the medial surface of the aorta to the level of the right renal artery in the aortic-caval gap is performed. Isolate and clip with two clips with a lock the right renal artery with turning off the blood flow in th
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