The dissection the renal hilum can be very demanding. Artery and vein should be identified and ligated. The artery is first isolated and divided between 9 mm titanium clips. This is followed by ligation and division between clips of the renal vein. This picture shows the kidney being lifted up once the vessels of the hilum have been divided.
Blunt dissection continues dividing any remaining attachments to the retroperitoneum.
Finally, the ureter is divided and the organ is ready for retrieval. The kidney is place in a plastic bag using the grasper holding the organ by the ureter to avoid injury and therefore tissue spillage When dealing with renal cancer, a 5 cm incision is made in the abdominal wall to allow the specimen to be retrieved under minimal tension. The plastic bag should be protecting the skin all the time.