Operative management of renal injuries

This chapter will cover the operative management of renal injuries encountered during the care of combat trauma casualties. Renal injuries may seem daunting to the elective general surgeon not accustomed to operating in the retroperitoneum or on the genitourinary system. However, a basic understanding of management of renal injuries is essential for the combat surgeon as the kidney may be injured by any mechanism, particularly in the setting of penetrating or blast injury. You are highly unlikely to have a urologist or transplant surgeon immediately available to assist you, but you can expertly manage renal trauma without them. This chapter will review indications for operation and renal exploration, operative exposure and injury evaluation, repair and resection (partial and nephrectomy) of the injured kidney, and postoperative complications.