肾前筋膜间平面无血腹腔镜上尿路手术入路精准解剖与技巧

doi:10.13418/j.issn.1001-165x.2017.02.003

Chinese Journal Of Clinical Anatomy ›› 2017, Vol. 35 ›› Issue (2): 130-136.doi: 10.13418/j.issn.1001-165x.2017.02.003

Technique of precise anatomical study on the bloodless-surgical approach of inter-prerenal-fascia planes in urological laparoscopic operations

MEI Ao-bing ^1，2, QIU Jian-guang³, JIA Ben-zhong⁴, SUN Fa⁴, SUN Xu⁵, Chen Mei¹, LIANG Xan-quan¹, HE Xiang¹, KANG Ting¹, HOU Jian-quan²

1.Department of Urology, The Second People’s Hospital of Guiyang，Guiyang, 550081, China；2. Department of Urology, The First Af?liated Hospital of Soochow University, Suzhou 215006, China; 3. Department of Urology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou 510630, China；4.Department of Urology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China；5. Department of Pediatric Surgery, The Affiliated Hospital of Guizhou Medical University,Guiyang 550004, China

Received:2016-06-05 Online:2017-03-25 Published:2017-04-27
Contact: HOU Jian-quan，E-mail: xf192@163.com IA Ben-zhong， E-mail: gzjbz @aliyun.com

Abstract

Abstract:

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.

Key words: Laparoscopic surgery；Inter-prerenal-fascia Planes； , Precise Anatomical；Planes surgery； , Checkmark sign

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Technique of precise anatomical study on the bloodless-surgical approach of inter-prerenal-fascia planes in urological laparoscopic operations

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