Nephrolympholysis

The kidney and adrenal gland are surrounded by perinephric or perirenal fat these together are enclosed by perirenal fascia or Gerota's fascia. Nephrolympholysis is the dissection of kidney from its surrounding perirenal fascia. Gerota's fascia is opened, and the kidney is dissected gradually out of the perirenal fascia (Fig. 5). The dissection is started posteriorly followed by dissection of the upper pole, lower pole, and finally the anterior surface. Once the kidney is mobilized all around, the dissection of the renal vessels is started posteriorly.

The vascular dissection is to be done with utmost care. The dilated perirenal and perihilar lymphatics are individually clipped and divided.

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