Gerotas fascia national library of medicine pubmed health. A nonfunctioning inflammatory kidney is a challenging surgical condition for urologists. Interstructural fascia is cobweblike fascia that runs through the structures of the body including the muscles. Gerotas fascia definition of gerotas fascia by medical. To avoid dissecting the perinephric adhesion, we applied the outside gerota fascia approach the same as in radical nephrectomy, with satisfactory results. It is a multilaminated structure which is fused posteromedially with the muscular fasciae of the psoas and quadratus lumborum muscles. Some investigators recommend open surgery because of the surgical difficulties caused by the inflammatory process, whereas others try to apply the advantages of a simple nonhandassisted laparoscopic approach. The spaces about the kidney are typically divided into three compartments. In laparoscopic nephrectomy, outside gerota fascia dissection of the kidney and enbloc ligation of the renal pedicle using endogia could reduce the difficulty of procedure and. Dimitrie gerota, a romanian physician, radiologist, and urologist who studied the anatomy and physiology of the bladder and appendix in the 1900s. The deeper layers below the renal fascia are, in order, the adipose capsule of the kidney or perirenal fat, the renal capsule and finally the parenchyma of the renal cortex. This type of fascia is commonly referred to as myofascial tissue or the fuzz and traditional textbooks might call it interosseous membrane, intermuscular septa, perimysium, endomysium, loose connective tissue and more.
A literature search using pubmed was also done for the period between 1990 and may 2011 using the terms gerotas fascia, perirenal fascia, and pelvic. Gerota fascia, gerotas capsule, renal fascia, perirenal fascia. The deeper layers below the renal fascia are, in order, the adipose capsule or perirenal fat, the renal capsule and finally the. Retroperitoneal spaces anatomy and perirenal collections epos. The posterior renal fascia, also called zuckerkandls fascia or fascia retrorenalis. The renal fascia separates the adipose capsule of kidney from the overlying pararenal fat. In laparoscopic nephrectomy, outside gerota fascia dissection of the kidney and enbloc ligation of the renal pedicle using endogia could reduce the difficulty of procedure and operative time, with satisfactory safety and reliability. However zuckerkandl did not recognize the separate anterior perirenal fascia. Laparoscopic adrenalectomy for adrenal tumors because there is a large space between gerotas fascia and the kidney, a large hemorrhage is required to compress the kidney. Know how this urinary structure looks like with the aid of these pictures. Surfaces of the perirenal fat of bilateral kidneys are covered by the gerota fascia, which consists of. Renal fascia anatomy, location, functions and images. At the lateral border of the kidney the renal fascia splits into an anterior and a posterior layer. He is also responsible for the creation of the gerota method, a technique used to inject lymphatic vessels.
Many of the patients affected by the 2020 coronavirus pandemic in romania are treated at this hospital. Right kidney was found to be free and was preserved. Giant retroperitoneal liposarcoma of gerotas fascia. In the medical literature, gerota fascia is frequently used as a general term to describe both the anterior and posterior pararenal fascia. Fenestration of the gerotas fascia as symptomatic treatment. Inflammation and adhesion extending beyond gerota fascia or involving renal hilum is an important. This result was in accordance with that of other researchers and further confirmed the feasibility and safety of outside gerota fascia dissection. And, during the advancement of surgical dissection, we found minute vessels, especially the venules, were present in this fascial plane and sometimes caused oozing of blood fig. Mcgovem, md, boston, massachusetts the greater omentum is commonly used when there is a surgical indication for a barrier between an aortic graft and the abdominal contents. The perirenal fascia is a dense, elastic connective tissue sheath that envelops each kidney and adrenal gland together with a layer of surrounding perirenal fat forming the perirenal space. Gerotas fascia was identified and opened to expose the upper pole of the kidney and the adrenal gland. This study aims to improve laparoscopic nephrectomy techniques for. The kidney and the adipose capsule are enclosed in a sheath of fibrous tissue continuous with the subperitoneal fascia, and named the renal fascia. Bent u hier via een pagina in wikipedia terechtgekomen.
Pdf the study aim was to explore the anatomy, histopathology, and molecular biological function of the fascias. The hospital, established on july 17, 1907, is now named the prof. On the anatomic territory of bilateral kidneys, the floor of toldt fascia fused securely with gerota fascia and to separate the two layers was technically unfeasible. Laparoscopic adrenalectomy for adrenal tumors because there is a large space between gerota s fascia and the kidney, a large hemorrhage is required to compress the kidney. Surfaces of the perirenal fat of bilateral kidneys are covered by the gerota fascia, which consists of dense connective tissue fibers. The renal fascia is involved in various urinary tract diseases, including acute renal infection, intrarenal and perirenal masses, focal renal scarring, and renal calculi to name a few. The anterior renal fascia, also called gerotas fascia after dimitrie gerota.
Pdf laparoscopic nephrectomy outside gerota fascia and en bloc. Chesbrough rm1, burkhard tk, martinez aj, burks dd. Structurally, we found that the toldts fascia was loose and even manifested as areolar tissues in texture. Pdf an anatomical, histopathological, and molecular biological. Histopathology report was suggestive of low grade well differentiated liposarcoma arising from gerotas fascia. Laparoscopic nephrectomy outside gerota fascia and en bloc. Laparoscopic nephrectomy outside gerota fascia for. Laparoscopic nephrectomy outside gerota fascia for management. The kidney and the adipose capsule are enclosed in a sheath of fibrous tissue continuous with the subperitoneal fascia. Within the anatomic territory of kidney, toldt fascia fused with gerota fascia, and then extended in all directions. Striscia di tela o di altra stoffa compatta e resistente che serve ad avvolgere, stringere e ornare.
A fibrous envelope of tissue that surrounds the kidney. The anterior renal fascia, also called gerota s fascia after dimitrie gerota. Dimitrie d gerota 18671939 4, a romanian professor of anatomy and surgery described his fascia in 1885 3 and at the same time named the posterior fascial layer after zuckerkandl. Sistema urinario e a parte do aparelho urogenital preferivel a genitourinario responsavel pela uropoese e pela conducao, armazenamento e eliminacao. Request pdf fenestration of the gerotas fascia as symptomatic treatment of floating kidneys a 16yearold man presented with severe nephrotic syndrome complicated by massive perirenal fluid. They concluded that the posteromedial part of the lateroconal fascia runs close to.
Gerotas name is associated with two eponyms and two histochemical methods, but he was also brancusis teacher and supervisor. The renal fascia or gerotas fascia is a layer of connective tissue encapsulating the kidneys and the adrenal glands. Gerota also founded a museum of anatomicalsurgical casts of his creation. Gerota documented the presence of the anterior renal fascia and clearly. However, zuckerkandls name is also often used to describe either the anterior or posterior fascia. It was remove in toto along with complete excision of gerotas fascia. The incision of gerotas fascia was made in a length of about 6 cm by using from the 1department of internal medicine. The renal fascia or gerota s fascia is a layer of connective tissue encapsulating the kidneys and the adrenal glands. Any information contained in this pdf file is automatically generated from.
636 711 1217 513 1290 698 1025 152 595 805 659 877 213 419 1443 672 7 210 1199 787 249 1362 1450 113 1636 1108 432 1179 1233 9 1379 645 171 131 1032 1190 1048 550 83 279 594 920