SAOP3- Kidney Surgery

The flashcards below were created by user Mawad on FreezingBlue Flashcards.

  1. Which kidney is located more cranially?
    right kidney
  2. Describe the vasculature of the kidneys.
    renal a enters at hilus--> branches to dorsal and ventral--> interlobar a--> interlobular a--> arcuate a
  3. What are suture considerations for the urinary system?
    • avoid non-absorbable suture
    • monofilament best (multifilament has irregular surface that is a nidus for bacteria)
    • avoid prolonged absorbable (bladder heals QUICKLY AND WELL)
    • suture size 3-0 to 5-0
  4. What are surgical approaches to the urinary tract?
    • ventral midline
    • paramedian
    • flank
  5. What are advantages of ventral midline approach?
    • provides exposure to all structures within the abdominal cavity
    • upper UT within retroperitoneal space
    • bladder ventral to colon within peritoneal cavity
  6. Flank approach facilitates exposure to what structures? (4)
    • kidney
    • ovary
    • adrenal
    • lymphatics
  7. What do you incise for the flank approach?
    • ext and int abdominal oblique
    • transversus abdominis (close all 3 separate muscle layers individually)
  8. What are potential complications of minimally invasive renal biopsy with tru-cut? (3)
    • small biopsy sample inadequate
    • location of sample non-diagnostic
    • hemorrhage, hemostasis
  9. When do we do a surgical biopsy instead of minimally invasive? (6)
    • celiotomy needed for other reasons
    • need to visualize both kidneys
    • patient with a bleeding disorder, need better hemostasis
    • need a larger tissue sample
    • position of kidney does no lend itself to percutaneous access
    • obese patient
  10. Where is the highest concentration of nephrons, ie. is the goal for biopsy location?
    • renal cortex
    • corticomedullary junction
  11. How do you position the tru-cut needle when performing a biopsy needle?
    • parallel to the long axis of the kidney
    • avoid hilar region
    • biopsy renal cortex
  12. What are considerations with open wedge biopsy of the kidney? (3)
    • use #10 or #15 scalpel blade to incise 4-6mm pie-shaped wedge from greater curvature
    • incise through cortex
    • expect hemorrhage and hematuria
  13. How do you close a renal wedge biopsy?
    4-0 absorbable suture to close renal capsule in simple continuous (avoid going too far into parenchyma, suture capsule)
  14. What are potential complications of wedge renal biopsy? (3)
    • hemorrhage- hematuria, subcapsular hematoma, hemoabdomen
    • laceration of renal pelvis- uroabdomen
    • insufficient biopsy sample- lack of nephrons
  15. How do you incise the kidney for nephrotomy?
    • incise along greater curvature to avoid major vessels
    • tourniquet hilus for 3-5 min max
  16. How do you close a nephrotomy incision?
    capsular suture with 3-0 to 4-0 chromic gut simple continuous
  17. What are potential complications of nephrotomy? (3)
    • hemorrhage
    • renal parenchymal injury, renal failure (hypoxia d/t tourniquet, surgical injury)
    • failure to completely remove obstruction
  18. Why is a pyelotomy?
    • surgical incision made directly into the dilated renal pelvis to remove nephroliths
    • does not require tourniquet, avoids injury to renal parenchyma
    • VERY difficult if the pelvis is not extremely dilated
  19. How do you close a pyelotomy?
    • 5-0 or 6-0
    • monofilament 
    • absorbable (monocryl)
    • simple continuous
  20. What is the purpose of a nephrectomy?
    • salvage procedure to remove a non-functional kidney (congenital dysplasia, hydronephrosis, pyelonephritis, neoplasia, trauma)
    • only is contra-lateral kidney is functional
  21. BUN/Cre are elevated with...
    75%+ loss of renal function
Card Set:
SAOP3- Kidney Surgery
2017-03-22 14:25:04
vetmed SAOP3

vetmed SAOP3
Show Answers: