TECHNICAL FEATURES OF THE KIDNEY LAPAROSCOPIC RESECTION WITH SUPER-SELECTIVE BALLOON EMBOLIZATION OF THE RENAL ARTERY

The article is devoted to the study of the results in the surgical treatment of patients with renal neoplasms using a new method of kidney resection, which has its own technical features. Their essence lies in the temporary superselective embolization of the renal artery, which allows turning off the affected part of the kidney from the circulation. Embolization allows minimizing the blood loss that occurs as well as preserving blood flow in the unaffected areas of the kidney, thereby protecting the remaining part of the kidney from ischemia. As a result, the postoperative period proceeds with a more rapid recovery of kidney function. Objective: to improve the results of renal neoplasms surgery. Materials and methods. Laparoscopic resection of the kidney with superselective balloon embolization from October 2015 to October 2017 was performed in 14 patients. The average age of the operated was 54.5 (from 29 to 72) years, among them 3 men and 11 women. Conclusion. The proposed method of superselective balloon embolization of the renal artery intraorganic branches has it's peculiarities which make it possible to perform a complete intraoperative hemostasis of the renal parenchyma segment in which the tumor-like formation is located. At the same time, the functional state of the rest of the kidney does not decrease, transluminal temporary embolization of the segmental or lobar artery of the kidney reliably blocks the blood flow, preventing massive uncontrolled bleeding. Maintaining blood flow to the intact parenchyma is an important factor in preventing acute kidney damage during organ-sparing operations. No need for skeletonization of the kidney arteries for their temporary clipping allows laparoscopic resection of the kidney to mid-level urological endosurgeon physicians without the help of highly skilled experts, which implies massive use of this technique in multidisciplinary clinics.