METHOD OF RETROPERITONEOSCOPIC ONE-STAGE NEPHRECTOMY FOR PYONEPHROSIS Russian patent published in 2023 - IPC A61B17/94 A61B5/00 A61B5/55 

FIELD: medicine; video endoscopic urologic surgery.

SUBSTANCE: measure degree of kidney mobility using ultrasound, determine state of the pararenal fat body and vascular pedicle using MRI in the preoperative period, In the absence of significant infiltration and paranephritis perform retroperitoneoscopy in side-lying position, exposure of psoas muscle and renal fascia with mobilization of kidney posterior surface, then perform US-guided pyonephrosis puncture and evacuate purulent contents from herenal cavitary system with wound expanding with electric suction machine. Then expose, mobilize and cut the vascular pedicle, and gradually mobilize kidney with pararenal fat body with inclusion of renal fascia and ureter. During the evacuation of purulent contents at the initial stage kidney volume decreases and working volume expands, so, on the one hand, access to the vascular pedicle is technically simplified, on the other hand, stages of isolating the kidney with pararenal fat body are simplified, and decrease in the kidney volume allows to remove it through smaller incision.

EFFECT: method allows to perform nephrectomy in case of pyonephrosis in one stage and remove kidney with pararenal fat body and renal fascia by reducing the volume of the kidney and ensuring an adequate approach to the kidney vascular pedicle and technical simplifying the stages of kidney mobilization.

1 cl, 2 ex