METHOD OF COMBINED BILATERAL NEPHRECTOMY IN PATIENTS WITH POLYCYSTIC KIDNEYS ON SUBSTITUTIVE RENAL THERAPY

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, namely to surgery and surgical urology. In preoperative multispiral computer tomography (MSCT), MSCT-angiography with intravenous reinforcement with 3D reconstruction of renal vessels is additionally performed. Laparoscopic access to the kidneys is performed, extraction, clipping and crossing of renal, ureteral vessels, kidneys removal. That is combined with preoperative MSCT-angiography with intravenous reinforcement with 3D reconstruction of renal vessels to evaluate vascular architectonics, and presence of additional arteries. Trocar along the median line is set at a distance equal to the width of the largest kidney according to MSCT data. It involves extraction, clipping and crossing of renal vessels, mobilization of an upper segment of the kidney with preservation of the adrenal gland with laparoscopic access in stages for each kidney in the patient's position on the back. Rotation is performed by an operating table, after which laparoscopic ports are removed and an open stage is performed, including an incision between trocars along the median line, final separation and removal of the kidneys through the incision.;EFFECT: method enables providing faster operation, thorough haemostasis and reducing the volume of operational blood loss, minimizing the abdominal wall injury, excluding the possibility of the abdominal cavity and operating wound infection, which reduces the rate of intra- and postoperative complications, accelerates postoperative rehabilitation, improves patient survival, reduces length of hospital stay and reduces economic costs at the surgical stage.;1 cl, 6 dwg, 1 ex