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Year : 2019  |  Volume : 35  |  Issue : 3  |  Page : 230-231

”Polar flip” technique for transperitoneal laparoscopic partial nephrectomy – Evolution of a novel technique for posterior hilar tumors


Department of Urology, Asian Institute of Nephrology and Urology, Hyderabad, Telangana, India

Correspondence Address:
Syed Mohammed Ghouse
Department of Urology, Asian Institute of Nephrology and Urology, Hyderabad, Telangana
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/iju.IJU_235_18

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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.


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