Dimitru, Roumanian anatomist and surgeon, 1867-1939. See: Gerota capsule, Gerota fascia, Gerota method.
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After incision of the Toldt line, the colon was reflected medially, and further peri-tumoral dissection between renal capsule and Gerota's fascia was performed.
The kidney was mobilized entirely outside Gerota's fascia, and the tumor with intact peri-renal fat was localized and scored using electrocautery and the adjacent kidney de-fatted.
The extent of dissection is superior to the inferior border of the pancreas and laterally overlying the Gerota's fascia.
All margins, including Gerota's fascia, ureteral and vascular, were free of malignancy.
When this maneuver is performed with the patient in the particular position (gravity--weight of the spleen and the tail of the pancreas), this allows the appropriate traction for further mobilization of the pancreas up to its body in the retroperitoneal space anteriorly, across the renal fascia (Gerota's), and the fused fascia of Toldt.
A retroperitoneal cavity was constructed by balloon dilation, followed by dissection of paranephric fat and Gerota's fascia.
(16,17) Briefly, after Gerota's fascia is opened, the renal capsule is visualized around the tumour.
The term "simple nephrectomy" describes the technique of removing the kidney from within the Gerota's fascia and is not a technically easy operation.
In addition to that, fluid accumulations in the perirenal area (black arrow), perirenal stranding, and thickening of Gerota fascia are visible