Clampless laparoscopic pure enucleation in pT1b RCC
Abstract
We present a case of 65-year-old gentleman with a 6 cm posterior mass of the right kidney. A clampless laparoscopic enucleation was planned.
The colon was deflected medially and the ureter was isolated.
The gonadal vein was transected and the renal hilum isolated.
A home-made tourniquet was placed around the two main arteries for an eventual clamping.
The isolation was challenging due to the hard and stuck renal fat.
The kidney was completely isolated in order to reach the mass. The enucleation was started and completed following the tumour capsule.
A resection bed suture was placed with 2-0 monocryl.
A sliding suture technique was done for renal parenchyma with vicryl.
At the end the renal capsule was closed and the kidney fixed to the abdominal wall.
The operation time was 110 minutes and the blood loss 300 millilitres.
The final histopathological report showed a pT1b cromophobe RCC.