Introduction: Conventional open surgical techniques allow proper surgical management for renal malignancies but have their intrinsic drawbacks. The aim of this paper is to present our technique in minimal renal exposure while avoiding the intrinsic complications of conventional techniques. Methods: We described our technique, which can be easily understood and replicated by urologists performing open kidney surgery. Results: Ninety-five patients had this technique done safely over the last 4 years, and 3 patients had this exposure changed into intraperitoneal extended wound for very large upper pole tumours. The median operating time was 70 min. No single patient required intraoperative blood transfusion. Median warm ischemic time was 9 min. Conclusion: Transverse lumbotomy is a safe reproducible technique that allows proper kidney exposure through a relatively smaller wound and avoiding unnecessary auxiliary techniques as rib resection, pleural tear management, and intraperitoneal exposure.

1.
Anastasiadis
E
,
O’Brien
T
,
Fernando
A
.
Open partial nephrectomy in renal cell cancer - Essential or obsolete?
[PMID: 27174506 DOI: 10.1016/j.ijsu.2016.05.031]
.
Int J Surg
.
2016
Dec
;
36
(
Pt C
):
541
7
.
[PubMed]
1743-9191
2.
Tennyson
LE
,
Lyon
TD
,
Farber
NJ
,
Correa
AF
,
Hrebinko
RL
.
Dorsal Lumbotomy Incision for Partial Nephrectomy in Patients With Small Posterior Renal Masses
.
[PMID: 26433081 DOI: 10.1016/j.urology.2015.09.023]
.
Urology
.
2016
Jan
;
87
:
120
4
.
[PubMed]
0090-4295
3.
Verma
A
,
Bajpai
M
,
Baidya
DK
.
Lumbotomy approach for upper urinary tract surgeries in adolescents: feasibility and challenges
.
[PMID: 24947345 DOI: 10.1016/j.jpurol.2014.05.001]
.
J Pediatr Urol
.
2014
Dec
;
10
(
6
):
1122
5
.
[PubMed]
1477-5131
4.
Braga
LH
,
Lorenzo
AJ
,
Bägli
DJ
,
Mahdi
M
,
Salle
JL
,
Khoury
AE
, et al.
Comparison of flank, dorsal lumbotomy and laparoscopic approaches for dismembered pyeloplasty in children older than 3 years with ureteropelvic junction obstruction
.
[PMID: 19914659 DOI: 10.1016/j.juro.2009.09.008]
.
J Urol
.
2010
Jan
;
183
(
1
):
306
11
.
[PubMed]
0022-5347
5.
Braga
LH
,
Lorenzo
AJ
,
Bägli
DJ
,
Keays
M
,
Farhat
WA
,
Khoury
AE
, et al.
Risk factors for recurrent ureteropelvic junction obstruction after open pyeloplasty in a large pediatric cohort
.
[PMID: 18708226 DOI: 10.1016/j.juro.2008.03.086]
.
J Urol
.
2008
Oct
;
180
(
4
Suppl
):
1684
7
.
[PubMed]
0022-5347
6.
Samarasekera
D
,
Kim
DS
,
Wang
R
,
Yip
G
,
Tang
SS
,
Nguan
C
.
Laparoscopy, dorsal lumbotomy and flank incision live donor nephrectomy: comparison of donor outcomes
.
[PMID: 23671511 DOI: 10.5489/cuaj.266]
.
Can Urol Assoc J
.
2013
Jan-Feb
;
7
(
1-2
):
E69
73
.
[PubMed]
1911-6470
7.
Bracco
LL
.
[Lateral transverse lumbotomy as a way of approach to the left retroperitoneal space; anatomo-surgical research]
.
Minerva Chir
.
1953
Jun
;
8
(
11
):
501
8
.
[PubMed]
0026-4733
8.
Gil-Vernet
J
.
New surgical concepts in removing renal calculi
.
[PMID: 5863978 DOI: 10.1159/000279382]
.
Urol Int
.
1965
;
20
(
5
):
255
88
.
[PubMed]
0042-1138
9.
Morozov
AV
.
[Surgical access in interventions on the kidney, adrenal gland and upper and middle third of the ureter]
.
Urologiia
.
2002
Jul-Aug
;
•••
(
4
):
16
20
.
[PubMed]
1728-2985
10.
van der Graaf
T
,
Verhagen
PC
,
Kerver
AL
,
Kleinrensink
GJ
.
Surgical anatomy of the 10th and 11th intercostal, and subcostal nerves: prevention of damage during lumbotomy
.
[PMID: 21683416 DOI: 10.1016/j.juro.2011.03.120]
.
J Urol
.
2011
Aug
;
186
(
2
):
579
83
.
[PubMed]
0022-5347
11.
Hjelle
KM
,
Johannesen
TB
,
Beisland
C
.
Postoperative 30-day Mortality Rates for Kidney Cancer Are Dependent on Hospital Surgical Volume: Results from a Norwegian Population-based Study
.
[PMID: 28753795 DOI: 10.1016/j.euf.2016.10.001]
.
Eur Urol Focus
.
2017
Apr
;
3
(
2-3
):
300
7
.
[PubMed]
2405-4569
12.
Hsu
RC
,
Salika
T
,
Maw
J
,
Lyratzopoulos
G
,
Gnanapragasam
VJ
,
Armitage
JN
.
Influence of hospital volume on nephrectomy mortality and complications: a systematic review and meta-analysis stratified by surgical type
.
[PMID: 28877947 DOI: 10.1136/bmjopen-2017-016833]
.
BMJ Open
.
2017
Sep
;
7
(
9
):
e016833
.
[PubMed]
2044-6055
13.
Xia
L
,
Pulido
JE
,
Chelluri
RR
,
Strother
MC
,
Taylor
BL
,
Raman
JD
, et al.
Hospital volume and outcomes of robot-assisted partial nephrectomy
.
[PMID: 29232025 DOI: 10.1111/bju.14099]
.
BJU Int
.
2018
Jun
;
121
(
6
):
900
7
.
[PubMed]
1464-4096
14.
Bajpai
M
,
Kumar
A
,
Gupta
AK
,
Pawar
DK
.
Lumbotomy approach for upper urological tract surgery in children—an analysis of 68 consecutive lumbotomies
.
[PMID: 15211405 DOI: 10.1055/s-2004-820903]
.
Eur J Pediatr Surg
.
2004
Jun
;
14
(
3
):
163
7
.
[PubMed]
0939-7248
15.
Onol
FF
,
Akbaş
A
,
Köse
O
,
Onol
SY
.
Short stay pyeloplasty with transverse dorsal lumbotomy incision: our 10-year experience
.
[PMID: 19819531 DOI: 10.1016/j.urology.2009.06.090]
.
Urology
.
2009
Dec
;
74
(
6
):
1309
12
.
[PubMed]
0090-4295
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