Access to urinary system v2

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undergraduate, Access to urinary system v2

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Access to urinary system v2

  1. 1. Urology Department Under-graduate coursesAccess to Genito-Urinary system By M.A.Wadood , MD, MRCS
  2. 2. For our Lectures and Scientific resourcesvisit our web sites, Uroainshams.blogspot.com Uronotes2012.blogspot.com ©
  3. 3. Approaches to Kidney By M.A.Wadood , MD, MRCS
  4. 4. Flank approach • Standard approach for renal & upper ureteric stones open surgery or simple nephrectomy or partial nephrectomy. • Can be used in renal or adrenal tumors if: small tumors, obese or unfit patients.  Subcostal.  Transcostal.  Supracostal (Intercostal).The patient is in the flank position. Gerota´s fascia is opened posteriorly, so that the peritoneal cavity is not entered. By M.A.Wadood , MD, MRCS
  5. 5. Anterior Transperitoneal approach• Standard approach for renal or adrenal tumors excision.• Involves: bilateral subcostal (Chevron) hemi-chevron midline incision.• allows access to the peritoneal cavity and inspection to rule out metastasis and/or extraadrenal disease. Chevron incision By M.A.Wadood , MD, MRCS
  6. 6. Anterior Transperitoneal approach Hemi-Chevron incision Midline incision By M.A.Wadood , MD, MRCS
  7. 7. Thoraco-abdominal approach• for exposure of large tumors and upper-pole tumors. By M.A.Wadood , MD, MRCS
  8. 8. Dorsal lumbotomy• for UPJ obstruction and stone surgery in children or thin patients By M.A.Wadood , MD, MRCS
  9. 9. Approaches to ureter By M.A.Wadood , MD, MRCS
  10. 10. Subcostal and anterior 12th rib supracostal incision Subcostal incision Anterior 12th rib supracostal incision• for upper ureteric stones or pathology By M.A.Wadood , MD, MRCS
  11. 11. Gibson and Abernathy incision• for mid-ureteric stones By M.A.Wadood , MD, MRCS
  12. 12. Lower Midline incision• for lower ureteric stones or pathology. By M.A.Wadood , MD, MRCS
  13. 13. Approaches to bladder and prostate © By M.A.Wadood , MD, MRCS
  14. 14. Lower midline incision• Standard approach for Bladder and prostate pathology surgery. © By M.A.Wadood , MD, MRCS
  15. 15. Pfannenstiel incision• Alternative minimally invasive approach but with less exposure. © By M.A.Wadood , MD, MRCS
  16. 16. Perineal incision for prostate• For radical perineal prostatectomy. © By M.A.Wadood , MD, MRCS
  17. 17. Percutaneous Cystostomy The bladder must be filled with 400 - 600 ml of saline until it can be palpable When the trocar is pushed into the bladder, the obturator is removed and fluid will escape. Immediatelly must be insert special catether through the sheat. By M.A.Wadood , MD, MRCS
  18. 18. Approaches to penis and urethra © By M.A.Wadood , MD, MRCS
  19. 19. Perineal incisions Mercedes perineal incision Midline perineal incision• To access bulbar and posterior urethra © By M.A.Wadood , MD, MRCS
  20. 20. Penile incisions Subcoronal incision Penoscrotal incision Midline penile incision• For penile and urethral surgery. © By M.A.Wadood , MD, MRCS
  21. 21. Approaches toinguinoscrotal structures © By M.A.Wadood , MD, MRCS
  22. 22. Inguinal incision Adult Pediatric (along skin crease)• For hernia, hydrocele & undescended testis in children and radical orchiectomy in adults. By M.A.Wadood , MD, MRCS
  23. 23. Varicocele incisionsSub-inguinal incisions inguinal incisions Balomo approach By M.A.Wadood , MD, MRCS
  24. 24. Scrotal incisionTransverse scrotal incision Incision over spermatocele By M.A.Wadood , MD, MRCS
  25. 25. Endoscopic urology © By M.A.Wadood , MD, MRCS
  26. 26. Flexible urethro-cystoscopy1. telescope;2. adapter for cold light,3. working adapter for introducing additional instruments,4. Alberran…5. adapter for irrigation inflow,6. adapter for irrigation outflow,7. sheath, By M.A.Wadood , MD, MRCS
  27. 27. Flexible urethro-cystoscopy By M.A.Wadood , MD, MRCS
  28. 28. Resection set• For TURP and TURBT• Contain: Lens, Working element, Loop and sheath. By M.A.Wadood , MD, MRCS
  29. 29. Rigid and flexible ureteroscopy By M.A.Wadood , MD, MRCS
  30. 30. Percutaneous nephrolithotomy (PCNL)- Nephroscope By M.A.Wadood , MD, MRCS
  31. 31. Nephroscope with lithotriptor By M.A.Wadood , MD, MRCS
  32. 32. Nephroscope with grasper By M.A.Wadood , MD, MRCS
  33. 33. Flexible Nephroscopy By M.A.Wadood , MD, MRCS
  34. 34. Laparoscopy in urology © By M.A.Wadood , MD, MRCS
  35. 35. Basic Laparoscopy set By M.A.Wadood , MD, MRCS
  36. 36. Techniques of peritoneal entry Verrese needle (classical technique) Open (Hasson technique) through infraumbilical incision By M.A.Wadood , MD, MRCS
  37. 37. Ballon for retroperitonoscopy By M.A.Wadood , MD, MRCS
  38. 38. TrocarBy M.A.Wadood , MD, MRCS
  39. 39. Graspers and Scissors By M.A.Wadood , MD, MRCS
  40. 40. Thank You By M.A.Wadood , MD, MRCS

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