Localization of segmental arteries in renal surgery by Doppler sonography.

To avoid damage to major arteries of the renal parenchyma during nephrotomy, intraoperative Doppler sonography was used experimentally and clinical as an artery finder. In experiments with 7 beagles segmental arteries were detected easily and reliably by sonography, and the arterial course thus indicated correlated perfectly with arteriograms and casts. In a clinical trial the Doppler artery finder was used in 7 patients with staghorn calculi that were removed via the renal pelvis and additional multiple selective nephrotomies with as many as 7 selective nephrotomies in a single kidney there was no damage to the major arteries in any of these patients. Selective, avascular nephrotomy with the aid of the simple, quick and reliable technique of Doppler sonography promises improved functional results of transparenchymal stone manipulation.