How is the operation performed?
The optimal access (transperitoneal or retroperitoneoscopic) is selected using the MSCT map; key structures are isolated and taken under control before working with the tumor, the feeding vessels are clipped, the formation is separated strictly along the capsule and immersed in a container - fragmentation is excluded. If there is intraoperative doubt, urgent histology is performed. This standard ensures both oncological safety and rapid restoration of minimally invasive access; further tactics (observation or treatment by an oncologist) are determined by the IHC conclusion.
Indications
- tumors of the retroperitoneal space according to MSCT/MRI - lipomas, schwannomas, paragangliomas, cysts;
- small sarcomas after additional examination and consultation;
- the need for complete removal with histological verification;
- growth of education during observation.
Features of retroperitoneal surgery
Retroperitoneal tumors grow asymptomatically for a long time and are found by chance; their surroundings - the aorta, vena cava, ureters, renal vessels - require precision technology. Laparoscopic access with magnification allows you to delicately isolate the formation and remove it entirely without opening the capsule (critical for possible sarcoma - disruption of the capsule worsens the prognosis). Preoperative MSCT and team experience determine safety; for large and invasive tumors, an open approach with an oncologist is chosen. All removed tissues are verified by IHC - observation or further treatment depends on the diagnosis.
