| 摘要 |
FIELD: medicine. ^ SUBSTANCE: invention refers to medicine, to urology, particularly to ligation of a renal pedicle during sclerosing pedunculitis in duplication of renal vessels or following earlier surgical procedure. That is ensured by nephrectomy in sclerosing pedunculitis with technologically feasible liberation of a renal vascular pedicle from cicatricial paranephric fat without separating elements of the renal pedicle. Then on the latter, starting in its bottom edge in parallel there are two vessel clamps applied with one of which being positioned distally, and another maximum in hilum of kidney at the distance at least 1 cm from the first one. Then tissues are gradually dissected between clamps at the periphery of the proximal one for 1/2 of a branch. In tissues straightened over a distal clamp, vessels of the renal pedicle are separated with defining their far edge and dissecting additionally the tissue between clamps if required. Then the vessel is ligatured and underrun. The whole mobilised strand is underrun again, now below the distal clamp of the vessel, and fastened. Then the distal clamp is shifted further along the renal pedicle with deepening its tip cantwise. Thereover, in hilum of kidney, behind the first proximal clamp, there is the next proximal clamp applied, with performing gradual ligation of the renal pedicle again. The near edge of the ligature underrun under the clamp is delivered over the applied ligature, with an overlap. The gradual ligation is performed to ensure complete ligation. ^ EFFECT: method allows carrying out safe nephrectomy in technically sophisticated environment and enables reliable ligation of an abnormally wide, rigid renal pedicle. ^ 3 dwg |
