Transverse Lumbotomy for Open Partial/Radical Nephrectomy: How I Do It

Urol Int. 2020;104(1-2):131-134. doi: 10.1159/000504787. Epub 2019 Dec 11.

Abstract

Introduction: Conventional open surgical techniques allow proper surgical management for renal malignancies but have their intrinsic drawbacks. The aim of this paper is to present our technique in minimal renal exposure while avoiding the intrinsic complications of conventional techniques.

Methods: We described our technique, which can be easily understood and replicated by urologists performing open kidney surgery.

Results: Ninety-five patients had this technique done safely over the last 4 years, and 3 patients had this exposure changed into intraperitoneal extended wound for very large upper pole tumours. The median operating time was 70 min. No single patient required intraoperative blood transfusion. Median warm ischemic time was 9 min.

Conclusion: Transverse lumbotomy is a safe reproducible technique that allows proper kidney exposure through a relatively smaller wound and avoiding unnecessary auxiliary techniques as rib resection, pleural tear management, and intraperitoneal exposure.

Keywords: Lumbotomy; Nephrectomy; Renal cell carcinoma.

MeSH terms

  • Carcinoma, Renal Cell / surgery*
  • Humans
  • Kidney / surgery
  • Kidney Neoplasms / surgery*
  • Minimally Invasive Surgical Procedures / methods*
  • Nephrectomy / methods*
  • Operative Time
  • Patient Positioning / methods
  • Postoperative Complications
  • Reproducibility of Results
  • Treatment Outcome
  • Urology / methods*
  • Warm Ischemia