Technique of precise anatomical study on the bloodless-surgical approach of inter-prerenal-fascia planes in urological laparoscopic operations
Chinese Journal of Clinical Anatomy ›› 2017, Vol. 35 ›› Issue (2) : 130-136.
Technique of precise anatomical study on the bloodless-surgical approach of inter-prerenal-fascia planes in urological laparoscopic operations
Objective To investigate the surgical technique of precise anatomical study on the bloodless-surgical approach of inter-prerenal-fascia planes in urological laparoscopic operations（IpULO）.Methods Autopsies, 320 slice CT scan images, and clinical laparoscopic surgery cases were included in this study to observe the morphological characteristic of the inter-prerenal-fascia planes. Results Inter-prerenal-fascia planes are the multiple-layer and avascular fascia in the anterior space of the kidney filled with spider silk lattice-like white fibrous tissue. There are seven important surgical planes involved in the IpULO procedure, which included from top to bottom: the interfascial plane of the Told’t, the plane between the colonic fusion fascia and the prerenal fusion fascia, the plane between the colonic fusion fascia and the prepancreaticoduodenal fusion fascia, the plane between the prerenal fusion fascia and the postpancreaticoduodenal fusion fascia, the plane between the prerenal fusion fascia and the anterior lamella of renal fascia, the plane between the perirenal fat and the anterior lamella of renal fascia, the subfascial plane of the anterior lamella of renal fascia. Conclusion Surgical approach is the key to accurate dissection operations like IpULO. Inter-prerenal-fascia planes are an important anatomical level in IpULO surgeric approach, which could significantly reduce erroneous dissection during IpULO procedure.
Laparoscopic surgery；Inter-prerenal-fascia Planes； / Precise Anatomical；Planes surgery； / Checkmark sign
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