Excision of the tumor
- Clampless partial nephrectomy without tumor enucleation is difficult to be performed. The correct plain for the excision of the tumor is the pseudocapsule between the tumor and the renal parenchyma. When the dissection is performed on this capsule, the bleeding from the renal parenchyma is limited.
- A combination of sharp and blunt dissection takes place for the excision of the tumor. The ultrasonic scissors and the bipolar forceps are used for the task. The lack of warm ischemia allows for meticulous hemostasis during tumor excision.
- The gas insufflations pressure has been increased to 18mmHg during the excision of the tumor.