Fig. 7

Renal mobilization and tumor exposure surgical processes of a patient with typical left-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 was carefully exposed. (D) Dragging down the kidney while dissecting its upper pole, then sealing the exposed nourishing vessels in the tumor surface with harmonic scalpel. (E) The kidney was fully mobilized by circumferentially dissecting its each side. (F) As the dissection progressed, the kidney had automatically tilted under the influence of gravity, and the tumor was progressively exposed