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Subrectus pouch for renal transplantation

Correct positioning of a renal transplant following implantation and revascularization is a vitally important and sometimes difficult part of the operation. If the renal vessels are, or become, kinked, acute thrombosis may result in graft loss. Kidney transplants arc normally positioned in the retroperitoneal space of the iliac fossa, lying in the gutter formed by the iliopsoas muscle (the traditional lateral position)1.2. In this position the vessels run medially from the hilum of the kidney and vessel kinking can usually be avoided by rotating the kidney carefully until the correct lie is found. Nevertheless some kidneys are difficult to position in this way and in these cases it is advantageous to place the transplant kidney in a specially fashioned subrectus pouch.