NEPHRECTOMY &

NEPHROTOMY
Dr. Abdul Mateen
NEPHRECTOMY

• Nephrectomy; Excision of the kidney

• Nephrotomy; Surgical incision into the kidney
• INDICATIONS;
• Renal cysts
• Nephrolithiasis
• Hydronephrosis
• Purulent Nephritis
• Kidney worms (Dictophyma Renale)
• Renal Neoplasms.
SURGICAL ANATOMY

• Retroperitoneal
• Embedded in adipose tissue
• Sublumbar position
• Right kidney = 1st-3rd lumbar vertebrae
• Left kidney: 2nd-4th Lumbar vertebrae
• Renal Artery from abdominal aorta
• Renal veins
• Hilus:
SURGICAL ANATOMY

• The kidneys lie in the retroperitoneal space lateral to the aorta and
caudal vena cava. They have a fibrous capsule and are held in
position by subperitoneal connective tissue. The cranial pole of the
right kidney lies at the level of the thirteenth rib. In an average-
sized dog, the cranial pole of the left kidney lies about 5 cm caudal
to the upper third of the last rib. The renal pelvis is the funnel-
shaped structure that receives urine and directs it into the ureter
SURGICAL ANATOMY

• The renal artery normally bifurcates into dorsal and ventral

branches; however, variations are common. The blood supply to
the ureter is from the cranial ureteral artery (from the renal artery)
and the caudal ureteral artery
BLOOD SUPPLY

• Renal artery directly

originate from abdominal
aorta.
• Renal vein directly drain
into posterior vena cava.
SURGICAL TECHNIQUE

• Recumbancy;
• Dorsal
• Lateral
• APPROACH;
• Ventral midline
• Flank
SELECTED ANESTHETICS

• Premedication;
• Atropine (0.02–0.04 mg/kg SC or IM
• Induction;
• a combination of xylazine plus ketamine I/V
• ( coctail of 2ml xylazine and 8ml of ketamine)
• Body weight; 14kg
• Dose; 1.4ml
• Maintenance; ketamine
PROCEDURE

• Ventral Mid Line Incision;

• First of all laprotomy is performed (surgical incision through
the abdomen at any point)
• For laprotomy:marking the area of incision
Cranial to umbliculs-midway to pubis caudally
• Making kidney free by stripping the peritonial reflection from it
• Index finger is inserted into the opening & peritonium is gently
peeled from kidney
PROCEDURE

• The kidney can be lifted from its bed to facilitate striping of

peri renal fat.
• Ligate blood vessels and ureter and check for spillage.
APPLICATION OF GENERAL
ANESTHESIA
LAPROTOMY
LIGATION OF RENAL VEIN
LIGATION OF URETER
REMOVAL OF RENAL CAPSULE
REMOVED KIDNEY
POST OPERATIVE CARE
POST OPERATIVE CARE

• ASD of the Incision site

• Good Management.
• Antibiotic Therapy
RECOVERED ANIMAL

•
• Will come
soon