Step 5 Excision of Overlying Renal Parenchyma

With the location of the diverticulum precisely demarcated, the nephrotomy incision is begun at the thinnest portion of the diverticulum, typically at the tip of the exophytic

FIGURE2 ■ Transperitoneal laparoscopic view of the left kidney with large anteromedial calyceal diverticulum. Intraoperative laparoscopic ultrasound is useful in localizing the diverticulum.

FIGURE3 ■ Wide excision of the thinned parenchyma overlying the large stone-bearing calyceal diverticulum.

FIGURE2 ■ Transperitoneal laparoscopic view of the left kidney with large anteromedial calyceal diverticulum. Intraoperative laparoscopic ultrasound is useful in localizing the diverticulum.

FIGURE3 ■ Wide excision of the thinned parenchyma overlying the large stone-bearing calyceal diverticulum.

dome. The overlying renal parenchymal tissue is circumferentially excised to expose the base of the diverticulum using monopolar electrocautery hook electrode or scissors, or harmonic/ultrasonic scalpel or shears (Fig. 3).

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