Alternatively, pledgeted matress sutures may be placed across the capsule. If possible the capsule is closed, or an omental flap closed over the defect. Nephrectomy is inidicated in the shattered kidney or renal pedicle injury in an unstable patient. The pedicle vessels are ligated separately, to avoid later arteriovenous fistula formation. The ureter is tied and kidney removed.
Retroperitoneal drainage is necessary post partial or total nephrectomy.
This should not be in contact with the renal collecting system. Injuries to other abdominal organs should be drained separately.