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Fig. 4 | BMC Urology

Fig. 4

From: Renal‑rotation techniques in retroperitoneoscopic adrenalectomy for giant pheochromocytomas: a clinical intervention study with historical controls

Fig. 4

Renal mobilization and tumor exposure surgical processes of a patient with typical right-sided giant pheochromocytoma

(A) Gerota’s fascia was adequately incised, incision upper bound reached the diaphragmatic crura. (B) Incision lower bound was down to the middle ureter level, to fully expose the entire kidney and lesion area. (C) Dorsal side of kidney was dissociated along the psoas major fascia, the renal pedicle area and inferior vena cava were carefully exposed. (D) Ventral side of kidney was subsequently dissected, and tumor was progressively exposed. (E) Dragging down the kidney while dissecting its upper pole, then sealing the exposed nourishing vessels in the tumor surface with harmonic scalpel. (F) As the dissection progressed, the kidney had automatically tilted under the influence of gravity

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