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SIMPLE NEPHRECTOMY - Page 1 of 2
The first laparoscopic simple Nephrectomy was done by Clayman in USA in 1990. Since then,
many large series have been published showing the many real advantages this technique has
over open Nephrectomy.
Chief of these are - shorter hospital stay and post surgical
recovery period and the remarkably painfree post operative period in comparison to open
surgery. The surgical complications are less when compared to open surgery. The main
disadvantage is the steep learning curve for the technique.
Case of RETROPERITONEOSCOPIC SIMPLE
NEPHRECTOMY - Rt. Side
Position of the patient
The patient is placed in the standard lateral position as for open Nephrectomy.
Port placement -
 3
or 4 ports are usually placed. The first port is placed below the tip of the 12th rib in
the posterior axillary line. A 2 cm incision is placed down to the retroperitoneal space.
The space is enlarged with a finger, pushing the peritoneum
anteriorly.
  A dilatation
balloon prepared by tying a glove finger over a rubber tube, is placed in the
reteroperitoneal space and distended to about 600 ml with saline.
 Four ports
were then used. 2 were on the posterior axillary line and 2 on the aneroir axillary line,
above and below the level of the umbilicus.
Cont. Page 2
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