METHOD FOR ACCESSING SUPRARENAL GLANDS Russian patent published in 2001 - IPC

FIELD: medicine. SUBSTANCE: method involves making soft tissue incision from posterior occipital line along the XI rib to the musculus rectum abdominis sheath. The broadest muscle of the back is moved aside. The distal part of the XI rib is excised. The internal oblique and transverse abdominal muscles are incised. The wound is dilated. The right and left angles of the colon are brought down. The internal abdominal fascia incision is continued backward. In performing right-sided access, the duodenum is mobilized. Triangular hepatic ligament is cut and the right lobe of the liver is shifted upward. The kidney is moved downward and inferior vena cava skeletization is carried out. Left-sided access being done, posterior peritoneum sheet is cut along the inferior border of the pancreas. The spleen and the pancreas tail are shifted upward. The kidney is moved downward. EFFECT: combined advantages of lumbar and abdominal access methods; good exposition of main blood vessels.