Applied anatomy of prerenal interfascial planes under the laparoscope
MEI Ao-Bing, QIU Jian-Guang, GU Ben-Zhong, GU Chang-Shi, SUN Fa, HUANG Yong-Gong, CHENG Hao, TU Zi-Jiang, ZHANG Piao-Chen, CHEN Gui-Quan
Chinese Journal of Clinical Anatomy ›› 2013, Vol. 31 ›› Issue (3) : 256-260.
Applied anatomy of prerenal interfascial planes under the laparoscope
Objective To explore in vivo the anatomical stratifications of prerenal interfascial planes under the laparoscope in search of the optimal "holy plane" of surgery. Methods A total of 28 cases were involved in this study undergoing the following procedures using the abdominal cavity approach in 3 cases and retroperitoneal cavity approach in 25 cases: 11 cases of adrenal tumor resection, 8 cases of nephrectomy, 2 cases of partial nepherectomy, 2 cases of radical resection of renal carcinoma, 3 cases of pyeloureteroplasty and 2 cases of removement of the upper ureteral calculus. Each patient underwent 320-row CT imaging preoperatively to analyze the anatomy of renal fascia. Sectional anatomical structure and adjoining relationships of the anterior renal fascia under the laparoscope were observed and analyzed intra-operatively and post-operatively, respectively. Results Prerenal interfascial planes are multiple, comprising the plane between the colonal fusion fascia and the prerenal fusion fascia, the plane between the prerenal fusion fascia and the anterior lamella of renal fascia, the plane between the colonal fusion fascia and the prepancreaticduodenal fusion fascia , the plane between the prerenal fusion fascia and the postpancreaticduodenal fusion fascia, the plane between the perirenal fat and the anterior lamella of renal fascia. They are avascular multiplanar fasciae, among the spaces of which the cobweb-like latticed white fiber fill. Conclusion Prerenal interfascial plane is a secure plane for anterior surgical approach related to the kidney and the adrenal gland .Through these planes, minimally invasive surgeries with little blood loss of retroperitoneal organs can be performed.
Laparoscopic / Anterior pararenal space / Prerenal interfascial planes / Prerenal fusion fascia / Planes surgery
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