Nozaki Tetsuo, Asao Yoshihiro, Ito Takatoshi, Tsuritani Shinji, Okumura Akiou, Fujiuchi Yasuyoshi, Fuse Hideki
Department of Urology, Graduate School of Medicine and Pharmaceutical Sciences for Research, University of Toyama, Toyama, Japan.
J Laparoendosc Adv Surg Tech A. 2011 Sep;21(7):629-33. doi: 10.1089/lap.2010.0295. Epub 2011 Jul 11.
A retroperitoneoscopic nephrectomy (RN) for symptomatic hydronephrosis (SH) is a challenging procedure because of the limited working space. This report describes a specific technical modification for efficient and successful RN for SH by using the SAND balloon catheter.
A 38-year-old woman underwent RN for SH caused by extrinsic compression of the ureter by a pelvic endometriosis. The SAND balloon catheter was directly inserted into the expanded hydronephrotic sac, and the liquid was extracted, appropriately. Urine leakage from the hydronephrotic sac could be avoided because the puncture site was sealed firmly between the two adjacent balloons at the tip of the catheter. Disposal counter traction using the catheter facilitated the mobilization of the hydronephrotic sac.
The patient was discharged 3 days after undergoing this procedure.
This method improves the surgeon's vision and facilitates resection without causing any injury to the hydronephrotic sac wall during RN.
由于工作空间有限，经后腹腔镜肾切除术（RN）治疗症状性肾积水（SH）是一项具有挑战性的手术。本报告描述了一种通过使用SAND球囊导管对SH进行高效且成功的RN的特定技术改良。
一名38岁女性因盆腔子宫内膜异位症导致输尿管外部受压而接受RN治疗SH。将SAND球囊导管直接插入扩张的肾积水囊中，并适当抽出液体。由于穿刺部位在导管尖端的两个相邻球囊之间被牢固密封，可避免肾积水囊漏尿。使用导管进行反向对抗牵引有助于肾积水囊的游离。
该患者在接受此手术后3天出院。
该方法改善了术者的视野，便于在RN期间进行切除，且不会对肾积水囊壁造成任何损伤。
