Dalton J R
Urology. 1984 Dec;24(6):564-6. doi: 10.1016/0090-4295(84)90102-x.
An operative approach to the kidney is described which takes advantage of the single attachment of the eleventh and twelfth ribs to their vertebral bodies, and an avascular plane that is present in the periosteal bed of the rib. By separation of the posterior attachments, the rib can pivot posteriorly and give a wide exposure of the kidney. By using an approach through the bed of the rib, the vascular supply to the intercostal space is avoided and less operative blood loss occurs. Saving the rib, rather than transecting it, avoids pleural and glove damage during the operation and adds a firmness to the wound not present when the rib is excised.
本文描述了一种肾脏手术入路，该入路利用第11和12肋与椎体的单一附着点，以及肋骨骨膜床中存在的无血管平面。通过分离后部附着点，肋骨可向后枢转，从而广泛暴露肾脏。通过经肋骨床入路，可避免肋间间隙的血管供应，减少术中失血。保留肋骨而非横断肋骨，可避免手术过程中胸膜和手套损伤，并使伤口比切除肋骨时更坚固。
