Supracostal approach--an excellent exposure for renal and adrenal surgery

Abstract

肋骨上縁切開法による腎及び副腎への腹膜外, 胸膜外到達法は, 肋骨の切除や神経血管束の損傷を回避しながら, 十分な視野の得られる優れた方法である.この到達法を33例の腎及び副腎手術で適用したところ, 全例, 肋骨の切除を必要とせず, 安全に手術を施行できた.合併症も殆ど認めず, 術後の創痛も少ないように思われた.この方法は肋骨や神経血管束を温存しながら, 良好な手術野が得られるので, 開放手術の際, 考慮すべき到達法の1つと考えられた

The supracostal extraperitoneal and extrapleural approach provides wide exposure during renal and adrenal operations without damaging the neurovascular bundles and spares the partial resection of rib. We performed renal and adrenal operations on 33 patients by this approach. The procedures were accomplished smoothly obtaining a broad surgical field without costal resection. Complications were rare and postoperative pain seemed to be mild. Hence, the supracostal approach is considered as a better method with excellent exposure to the kidney and adrenal and is anatomically comprehensive.