Decubitus positioning, a free method to allow access, organ protection in thermal ablation and exclusion of liver involvement of an anterior cortex renal tumour

Tan Zehao*, Teo Jin Kiat, Terence Lim Say Kiat, Poh Wee Teng and Ng Keng Sin

Renal tumours are getting detected earlier and smaller owing to increase in imaging volume with renal cell carcinoma as one the top 10 most common cancer in Singapore. With ageing population, this is expected to be seen in patients with multiple co-morbidities raising challenges for surgical management.

Exclusion of hepatic invasion by renal tumours in the anterior cortex is usually difficult. Access for biopsy and ablation of renal tumours at the anterior cortex is also an issue with trans-hepatic, retroperitoneal approaches risking injury to the liver and posterior aspect of the kidney and an anterior trans-peritoneal approach risking bowel perforation and tract seeding. 

The liver is an intra-peritoneal organ while the kidney is retroperitoneal. With this anatomical knowledge, we present a case which uses decubitus positioning to provide path for access, organ protection and to exclude hepatic involvement. This is free and serves as an example for cost saving measure in an economy of rising healthcare cost due to an aging population. 

Keywords:

Published on: Oct 28, 2020 Pages: 73-75

Full Text PDF Full Text HTML DOI: 10.17352/aur.000023
CrossMark Publons Harvard Library HOLLIS Search IT Semantic Scholar Get Citation Base Search Scilit OAI-PMH ResearchGate Academic Microsoft GrowKudos Universite de Paris UW Libraries SJSU King Library SJSU King Library NUS Library McGill DET KGL BIBLiOTEK JCU Discovery Universidad De Lima WorldCat VU on WorldCat