Personnel and Equipment Configuration

In addition to the operating surgeon, laparoscopic renal cyst ablation requires the following personnel: a surgical assistant, scrub technician, circulating nurse, and anesthesia team. During the transperitoneal approach, both the operating surgeon and the assistant stand on the abdominal side of the patient, contralateral to the targeted kidney. A typical operating room configuration for a left transperitoneal laparoscopic renal cyst ablation is shown in Figure 5. The scrub nurse and equipment table are situated near the surgical team at the foot of the table. The operating table must be adjustable and allow for lateral rotation. Two towers or cabinets equipped with a color video monitor mounted at eye level, light source, and carbon dioxide gas insufflator are placed on either side near the head of the table to allow the operating surgeon, assistant, and scrub technician to view and continuously monitor the surgical procedure. A video camera is attached to the laparoscope and its display projected on both video monitors. A standard electrocautery unit is placed either in front or behind the operating surgeon. If the AESOPĀ®a robotic arm is employed to stabilize and control the laparoscope, it should be attached to the operating table on the side contralateral to the kidney of interest and at the level of the patient's shoulders, taking great care to ensure that it does not come in contact with the patient's hands, arms, or shoulder during maneuvering of the robotic arm.

During the retroperitoneal approach, the surgeon and assistant stand facing the posterior flank of the patient with the side of the kidney of interest facing upward (Fig. 6). An operating table equipped with a kidney rest and that allows for flexion is important for the retroperitoneal technique.

0 0

Post a comment