The surgery is done under general anesthesia. After giving general anesthesia, urinary catheter, radial arterial line and nasogastric tube are inserted. An epidural catheter is also placed for postoperative pain management.
For transperitoneal approach, the patient is put in supine position with both arms abducted at 90 degrees. The patient is scrubbed and prepped from level of nipples to the knees and draped widely for access to entire abdominal cavity and femoral arteries. All these procedures are carried out in a sterile manner.
For retroperitoneal approach, the patient is put in 40-60 degrees right decubitus position and left arm is supported with an arm support. After this, the kidney rest of the bed is elevated and the bean bag is inflated to maintain proper position of the patient. In order to increase the space between the iliac crest and costal margin, further flexion of the table can be done.
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