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Large Thoraco abdominal incision.
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The incision was started in the thorax in the left bed of the 11th rib, just below the 11th and extended towards the abdominal cavity as far caudally as the umbilicus, Fig. 3.
Lateral wall of mass is being mobilized.
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Attention now to upper pole as its separated from adrenals.
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Lateral and apical margins cleared.
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At surgery, the left renal mass was delivered into the wound by a series of traction and pulsion manoeuvres, Fig. 6.
The 8 pounder is now prepared for final delivery.
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They were all ligated with 0 vicryl and the tumour delivered and weighed, Fig. 7, Fig. 8.