'Intertransversalis' approach for laparoscopic urology: Surgical anatomy concerns

摘要

At the kidney, the membranous layer should be continuous with renal fascia, which is the local condensation of retroperitoneal tissue.2-4 Instead, Li et al1 added a deep layer external to the renal fascia (see the red lines in their Figures 1A and 5A), separating their balloon-dilated compartment from pararenal space and preventing direct access to renal fascia that envelops renal vessels (see Figure 1A in Li et al1). Their figures erroneously show the renal fascia not enveloping the renal vessels' root, aorta, or inferior vena cava.Infraumbilically (see Figures IB and 5 in Li et al1), the deep layer of TF is shown in lieu of umbilical prevesical fascia (another condensation of preperitoneal tissue3). Other extraperitoneal condensations comprise the me-sorectum (empty space around the rectum [see Figure 5D in Li et al1]), the rectoprostatic fascia, and other "packings" of extraperitoneal splanchna.