What Is the Renal Sinus?

It is the cavity surrounded by the parenchyma of the kidney. Its inward opening is called the renal hilum, and it is the portal through which the renal blood vessels, renal pelvis, lymphatic vessels, and nerves enter and exit. The edge of the hilum is called the kidney lip, which divides the anterior, posterior, and upper and lower lips of the kidney.

It is the cavity surrounded by the parenchyma of the kidney. Its inward opening is called the renal hilum, and it is the portal through which the renal blood vessels, renal pelvis, lymphatic vessels, and nerves enter and exit. The edge of the hilum is called the kidney lip, which divides the anterior, posterior, and upper and lower lips of the kidney.

Chinese name

Renal sinus

Foreign name

sinus renalis

Department

Nephrology

Overview of the renal sinus

In addition to renal blood vessels, lymphatic vessels and nerves in the renal sinus, there are kidney calyces, kidney calyces, renal pelvis and adipose tissue. After the renal pelvis exits the renal hilum, it migrates to the ureter.

Sinus Kidney Fat

Fat is a normal part of the supporting tissue that surrounds the renal pelvis. Sometimes the sinus fat is very rich, making it appear as a low-density area on the medial side of the kidney on plain film. Renal tumors based on muscle and fat, such as angiomyolipoma (hamsteroid tumor), have been observed on plain film for fat. Only a few cases have been reported. It appears as an unclear bordered translucent area within the renal shadow. However, most angiomyolipomas cannot be shown on plain film due to lack of sufficient fat. And this behavior is not specific, because it is also seen in eosinophilic tumors involved in renal sinus fat.

Renal sinus intrarenal pyelotomy

(A) surgical anatomy

The renal sinus is a cavity surrounded by the renal parenchyma of the renal fornix to the hilum, and contains the renal pelvis, renal blood vessels, and lymphatic vessels. At the edge of the hilum, there is a thick fibrous sheath, which is attached to the renal fibrous sac, and surrounds and attaches to the part of the renal pelvis and renal arteries and veins, which is just at the entrance of the renal sinus, called the hilar capsule Interval. It was found that there was a dense fibrous fat capsule from the upper part of the ureter to the kidney papilla. This dense fibrous fat capsule was called the renal sinus fat capsule. There is a gap between the renal sinus fat capsule and the adrenal pelvis, called the extrapelvic space, which contains loose connective tissue, and no vascular structure is seen.

The posterior renal artery enters the renal sinus in the upper part of the renal hilum, spans the posterior and upper part of the renal pelvis, and crosses the point at the junction of the renal pelvis and the kidney, and sends out the posterior transverse renal artery. This artery crosses the posterior artery of the renal pelvis or anastomosis of the lower artery at the junction of the renal pelvis and the kidney. The trunk of the posterior segment of arteries is divided into dendritic or arcuate shapes and descends along the deep side of the posterior lip of the kidney. The branches along the way enter the renal parenchyma along with or behind the kidneys.

(Two) the main points of surgery

1. The separation of the renal pelvis in the renal sinus must be performed along the extrapelvic space. When the inflammation in the renal sinus or around the pelvis is obvious, first find the fat capsule of the sinus in the upper part of the ureter, reach the hilar horizontal line, and cut the hilar envelope in the direction of the lower kidney to enlarge the hilar. The blunt separation reached the deep part of the renal sinus and the funnel part of the renal calyx, and the separation range was large.

2. The incision is appropriately selected according to the height of the kidney, the position, shape, size, number of stones and the difficulty of removing the stones. A low back straight incision is suitable for simple renal pelvis stones with a lower kidney position. The 11th or 12th rib incision is suitable for multiple, small deer horn-shaped multiple kidney stones with a high kidney position.

3. For those who have multiple stones or broken stones and take them in blocks, they must carefully check for residual stones.

4. Incision of the deep part of the renal pelvis or the calori funnel should be performed under direct vision, so as not to accidentally damage the arteries in the posterior segment of the renal sinus, the arteries of the lower segment, and the vessels of the caliber.