Most kidney injuries can be managed non-operatively, but not all of them!
➡️ THINK 🧠 before opening the retroperitoneum. Do you have to? Indications 🟰 active bleeding🩸, expanding or pulsatile hematoma ❤️, &/or destructive injury to the renal hilum.
➡️ If you explore & don't perform a nephrectomy, always leave drains!
NePhReCtOmY🫘
➡️ Perform a medial visceral rotation
➡️Open Gerota’s fascia, scoop the kidney out, & medialize it like you would the spleen.
➡️Isolated & ligate the hilar structures - take ureter distally w/ absorbable suture.
👀 the 📺 from @BehindTheKnife TRAUMA SURGERY VIDEO ATLAS: https://t.co/6cbVAgBGLy
Described as a "bladder pacemaker," sacral neuromodulation (SNM) is traditionally performed for patients with neurogenic bladder.
A subcutaneous pulse generator sends impulses via electrodes through the S3 sacral foramen to modulate nerve signaling and restore bladder function.