**3.1.1 Definition, surgical technique**

Urologic surgeons are increasingly proposing careful, pure enucleation consisting of an incision of the renal parenchyma within a few millimetres of the tumour, followed by a blunt dissection following a plane between the pseudo-capsule and the healthy renal parenchyma, thereby minimizing loss of nephrons.

Fig. 2. Enucleation.

Fig. 3. Wedge Resection.

336 Chronic Kidney Disease

team use the following schema: 12,5 g mannitol are administered ten minutes before resection and the same additional dose is given at removal of the clamp (Weizer et al., 2011). The use of an angiotensin-converting enzyme inhibitor such as enalapril has also been proposed. This should theoretically prevent vasospasm and induce vasodilatation. To prevent thrombosis, administration of heparin intravenously has been proposed but its

Other important points are to maintain a normal blood pressure and hemodynamic stability

Urologic surgeons are increasingly proposing careful, pure enucleation consisting of an incision of the renal parenchyma within a few millimetres of the tumour, followed by a blunt dissection following a plane between the pseudo-capsule and the healthy renal

Fig. 1. Cooling.

benefit has not been proved.

**3.1 Simple enucleation** 

Fig. 2. Enucleation.

in the peri-operative and postoperative period.

parenchyma, thereby minimizing loss of nephrons.

**3. Alternative surgical techniques** 

**3.1.1 Definition, surgical technique** 
