Lateroconal fascia suspension facilitates retroperitoneal partial nephrectomy

Abstract

Background As the development of various imaging techniques, the incidental detection of renal masses is increasing. Laparoscopic partial nephrectomy (LPN) is the current standard of treatment for renal carcinoma. Though the retroperitoneal laparoscopic partial nephrectomy (RLPN) become the prior choice, the edge of lateroconal fascia blocks the sight and make operation more challenging. Methods Between October 2018 and December 2020, the clinical data of 28 cases diagnosed with renal cell carcinoma (RCC) in our hospital was collected and analyzed retrospectively. All patients underwent RLPN and for management of curtain effect, we performed lateroconal fascia suspension (LFS) procedure in all cases with prepared Hem-o-lock clip which bound with 2-0 suture. Results RLPN for renal tumor was successfully performed in all cases with no conversions to open surgery and other interruptions. In all cases, the free edge of lateroconal fascia and peritoneum partially blocked the sight of surgeon. We managed the curtain effect successfully and got a satisfying field of view for subsequent surgical procedure. The median operation time was 142 [interquartile range (IQR), 110–164] min, median estimated blood loss was 93 (IQR, 50–100) mL. Median warm ischemia time was 29 (IQR, 22–30) min. Conclusions LFS is useful for management of curtain effect. It is a simple, economical and less invasive technique and we can get better efficiency with little consumption.

Trans-retro-peritoneal laparoscopic partial nephrectomy for posterior hilar tumor: technical feasibility and preliminary results

“…Conversely, if the tear is enlarged excessively, it might cause abdominal tissues and intestines to protrude into the retroperitoneal space, potentially causing harm during subsequent surgeries. Such damage could elevate the risk of bowel injury and postoperative intestinal adhesions ( 17 ). Prior to the current study ( 3 ), attempts were made to rotate the kidney ventrally without disrupting the peritoneum after completely separating the kidney from the fat layer during retroperitoneal LPN.…”

Fascial Nomenclature: Update 2024

“…Compared to the previous nomenclature, we have added the CSF, which has a double phylogeny, and the coverings of some viscera, such as the pleura and the structure of the pericardium, Glisson's capsule (or Glisson's hepatobiliary sheath), renal capsule (anterior fascia of Gerota, posterior fascia of Zuckerkandl, lateroconal fascia), paraneurium, joint capsule, which structures derive from the mesoderm [67,[69][70][71][72][73].…”