(10) The fascia and muscles are closed in layers with interrupted chromic
sutures. If necessary, retension sutures may be used. The skin edges are
approximated with interrupted sutures of silk or wire or with skin clips.
(11) The drain is secured and the wound dressed with gauze sponges,
abdominal pads, and adhesive strips.
a. General. This procedure involves the partial excision of the kidney, and is
otherwise similar to nephrectomy.
b. Operative Procedure. This procedure is usually indicated when one pole of
the kidney has been destroyed by localized disease, such as an obstructive calculus.
The rest of the kidney is healthy. This condition may be the result of a kidney being
formed with two collecting systems. The capsule is pushed back, and a wedge of
kidney tissue is resected, which includes the diseased or damaged cortex, pelvis, and
vessels. The healthy kidney tissue is sutured with gut, the capsule is replaced and a
pad of fat is sutured over the line of closure. A nephropexy will probably be done also
to ensure good position and drainage.
3-16. PROCEDURES FOR OPENING THE KIDNEY
(1) Nephrotomy is an incision into the kidney. A simple incision and
drainage may be required for hydronephrosis, cyst, or perinephritic abscess.
Pyelotomy is an incision into the renal pelvis.
(3) Pyelostomy is an incision into the renal pelvis to establish drainage or to
permit irrigation of the renal pelvis.
(4) Pyelolithotomy is the removal of a stone or stones through the opening
made in the renal pelvis.
(5) Nephrostomy is an opening into the kidney to maintain temporary or
permanent drainage. A nephrostomy is used to correct an obstruction of the urinary
tract, conserve and permit physiological restoration of renal tissue that has been
impaired by disease, provide permanent drainage when a ureter is unable to function,
treat anuria as an emergency measure, or drain a kidney during the postoperative
period following a plastic repair on the kidney or renal pelvis.
(6) Nephrolithotomy and pyelonephrolithotomy are essentially the same,
since one is simply an extension of the incision. This is done in order to remove a large