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. 2019 Jul-Sep;35(3):230-231.
doi: 10.4103/iju.IJU_235_18.

"Polar flip" technique for transperitoneal laparoscopic partial nephrectomy - Evolution of a novel technique for posterior hilar tumors

Mallikarjuna Chiruvella  1 , Syed Mohammed Ghouse  1 , Ashwin Sunil Tamhankar  1
Affiliations

"Polar flip" technique for transperitoneal laparoscopic partial nephrectomy - Evolution of a novel technique for posterior hilar tumors

Mallikarjuna Chiruvella et al. Indian J Urol. 2019 Jul-Sep.

Abstract

Posterior hilar renal tumor extirpation by partial nephrectomy is a unique challenge for transperitoneal laparoscopy. We describe our novel technique of "polar flip" for these tumors. Kidney is rotated by around 45 -60 degrees after mobilisation so that lower pole faces anteriorly and upper pole faces posteriorly, thereby exposing the posterior surface for maneuverability. Technical highlights are hilar control, complete kidney mobilisation, initial flipping with dissection in Gil Vernet's plane to clip posterior segmental renal artery, en mass hilar clamping in normal lie, polar flipping, dissection in Gil Vernet's plane till renal sinus fat, completion of tumor excision, selective vascular ligation, renorhaphy and nephropexy.

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Conflict of interest statement

Conflicts of interest: There are no conflicts of interest.

Figures

Figure 1
Figure 1
Contrast enhanced CT scan of the tumor
See this image and copyright information in PMC

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