Urology >>>> Suturing the kidney - nephropexy

Suturing the kidney - nephropexy.

Nephropexy, an operation to suture the kidney, is necessary in cases where the kidney is excessively mobile or descends with an upright position of the human body for a distance greater than three vertebral bodies. When choosing a surgical intervention as a treatment for a mobile kidney, the patient's condition is taken into account:

Severe pain symptoms that disrupt well-being and deprive a person of working capacity;
Bleeding from the vessels that provide blood supply to the mobile kidney;
Kidney disease that does not respond to drug therapy and is caused by kidney motility.

There are a number of contraindications for nephropexy:

Acute inflammatory foci in the body;
The advanced age of the patient;
Descent of all organs of the abdominal region;
Concomitant diseases that increase the risks of nephropexy (diabetes mellitus, anemia, cardiovascular pathologies, etc.).

There are two possibilities for the kidney suturing operation: abdominal surgery and laparoscopic surgery (laparoscopic transperitoneal nephropexy).

Laparoscopic intervention has advantages, since it is a minimally invasive intervention with the patient's rehabilitation period much shorter than with abdominal surgery - discharge on the sixth day, restoration of working capacity in two weeks. With abdominal surgery, bed rest is two to three weeks. Both operations are performed under endotracheal anesthesia.

Kidney suturing techniques:

Placement of a kergut suture in the renal fascia and suspension of the kidney to the twelfth rib and muscles of the lumbar spine;
Suspension of the kidney to the twelfth rib using connective tissue flaps;
Fixation of the kidney to the ribs using muscle flaps;
Suspension of the kidney to the ribs by means of a special attachment (mesh implant) made of nylon, nylon, polypropylene or other synthetic materials.

Recently, preference is given to synthetic mesh implants, which cause fewer postoperative complications and have a more reliable structure than connective tissue or muscle flaps.