METHOD OF RETROPERITONEOSCOPIC ACCESS WHEN PERFORMING ONE-STAGE NEPHRECTOMY IN CASE OF PURULENT PROCESSES IN THE KIDNEY AND PERIRENAL TISSUE Russian patent published in 2023 - IPC A61B17/94 A61B17/34 A61M25/01 

FIELD: medicine, urology.

SUBSTANCE: in the position of the patient on a healthy side under ultrasound control, a purulent area is punctured. The wound is expanded, an electric pump is introduced into it and the purulent contents of the retroperitoneal space is evacuated. The purulent cavity is washed. Then the electric pump is removed, a 10 mm trocar with a laparoscope is inserted in its place, and a retropneumoperitoneum is created by insufflation of CO2. Additional trocars are introduced along the anterior and middle axillary lines, revision and sanitation of the retroperitoneal space are carried out. Further along the lumbar muscle, the posterior surface of the kidney, renal vessels with bipolar tissue coagulation are exposed, the kidney is mobilized along the posterior surface and renal vessels, and nephrectomy is performed. A circular polyvinylchloride drainage is installed in the retroperitoneal space and in the postoperative period the retroperitoneal space is irrigated with an antiseptic, an aqueous solution of chlorhexidine for 2 days.

EFFECT: method allows to perform nephrectomy in one stage, improves visualization of the surgical field, improves the efficiency of treatment of patients with purulent-inflammatory diseases of the kidneys and retroperitoneal space, reduces the risk of dissemination of the purulent process, eliminates the risk of infection of the abdominal organs, creates adequate access to the kidney and vascular pedicle, prevents intraoperative wound complications and the occurrence of postoperative complications.

1 cl, 2 ex