Study of laparoscopic anatomical features of retroperitoneal cavity around kidney and surgical access for laparoscopy
- VernacularTitle:肾周腹膜后隙腔镜下解剖特征及其临床应用
- Author:
Jianguang QIU
;
Xin GAO
;
Jianguo ZHU
- Publication Type:Journal Article
- Keywords:
Laparoscopy;
Kidney;
Anatomy;
Lateral co nal fascia;
Fusion fascia
- From:
Chinese Journal of Urology
1994;0(02):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To study the anatomical feature s of the retroperitoneal cavity around kidney under laparoscope and to provide ana tomical guidance for laparoscopic surgery. Methods Lapar oscopic renal and ureteral operations were performed on 241 patients (145 men an d 96 women; age range,16-75 years;mean age,45.3 years).Through the videos and ph otographs of these operations,the anatomical features were analyzed.The atlas wa s drawn and surgical access was designed. Results Under laparoscope lateral conal fascia continues from the fascia of quadratus lumborum at its lateral border.This fascia covers posterior lamella of Gerota’s fascia and fuses into transversalis fascia beneath peritoneum. Fusion fascia lies befor e anterior lamella of Gerota’s fascia. It extends laterally and disappears grad ually to the lateral reflexion of peritoneum.The plane between fusion fascia and anterior lamella of Gerota's fascia, the plane between lateral conal fascia and posterior lamella of Gerota’s fascia, the plane before the quadratus lumborum and psoas major, are all vessel-free planes.Lateral border of colon,peritoneum and fusion fascia form a triangle lateral to colon.Fusion fascia,lateral conal f ascia and Gerota’s fascia form a vessel-free triangle. Conclusions Dissection through the vessel-free planes prevents laparoscopic op erations from bleeding and organ injury.Full understanding of the laparoscopic a natomical features of the retroperitoneal cavity around kidney provides the anat omic theoretical basis for laparoscopic operations.
