Laparoscopic Renal Cyst Deroofing for renal clear cyst

Laparoscopic Renal Cyst Deroofing FOR LAGRE RENAL CYST

1. Laparoscopic Renal Cyst Deroofing

2. What is Renal Cyst? A simple kidney cyst is the most common type of renal cyst. It is a fluid-filled sac that originates from the surface of the kidney. One or more simple cysts may form within the same kidney. These cysts are usually asymptomatic and detected incidentally upon radiological exams of the abdomen.

3. What are the types of renal cyst ?

4. Investigations for Renal Cyst Ultrasound CT KUB CECT Urogram

5. Treatment of renal cyst Open – Laparotomy – Deroofing of renal cyst Laparoscopic - Deroofing of renal cyst

6. Laparoscopic Deroofing Position- Left Lateral or Right Lateral

7. Instruments – Telescope, Harmonic, Ports, Graspers, Needle Holder

8. Laparoscopy – Port positioning 3 or 4 ports needed

9. Step 1 the line of Toldt is incised from the iliac vessels to the splenic or hepatic flexure and the colon is mobilized medially

10. STEP 2: On the right side, the colon is reflected, and a Kocher maneuver may be performed to completely expose the kidney and the renal hilum.

11. Step 4: A curved dissector, in the left hand, is placed beneath the ureter and used to provide anterolateral elevation and ureter identified

12. STEP 5: The cyst fluid is aspirated with a laparoscopic aspiration needle. After decompression of the cyst, the wall can easily be grasped and manipulated. The cyst is elevated with a grasper and scissors or ultrasonic shears to circumferentially excise the cyst wall. The edge of the cyst is carefully inspected, and biopsies are performed using the 5-mm laparoscopic biopsy forceps as needed.

13. Step 6: Drain placement after renal cyst excision. If the collecting system has been entered, it is closed and a drain placed. To insert the drain, a hemostat is passed through a small stab incision in the side and advanced into the abdominal cavity under direct vision.

14. A drain is placed through a trocar site and advanced toward the open hemostat using the trocar to direct the drain. The colon is brought back over the kidney and attached to the sidewall to “ reperitonealize ” the kidney and drain.

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