上部尿路手術における背部直垂切開法(Simon-Young incision)の検討

概要

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The advantages of Simon-Young's incision are that it avoids injury to the important structures, causes little bleeding and leaves no postoperative hernia. It also gives a direct approach to the kidney. Then, the large pyeloinfundibulotomy by Gil-Vernet allows the extraction of staghorn calculi under the surgeons' direct observation. Sixteen operations on the upper urinary tract were performed by this surgical approach. They were pyelolithotomy, ureterolithotomy, nephrectomy, ureterocutaneostomy and lymph channel dissections of the renal pedicle. Vertical incision of Simon-Young was felt to be adequate for the upper urinary tract operation. However, pyeloinfundibular transverse incision of Gil-Vernet for renal calculi was thought to be unsuitable in the cases of obesity, adhesive renal pedicle or bulging renal parenchyma over the hilus.