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If converting laparoscopic to open because of uncontrolled bleeding, consider permissive hypotension until haemostasis is achieved. Take vascular comorbidities into account when deciding how low.

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Check Hb. Anemia may be present from hematuria. refl.in/9f

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If the patient has had previous abdominal surgery there may be surgical access issues making an open conversion more likely when performing a laparoscopic assisted nephrectomy.

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Intra-arterial blood pressure monitoring as there may be rapid blood loss

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Usually performed in the full lateral position with either padding or table positioning (“breaking” the table in the middle) to raise the loin and improve surgical access. refl.in/9f

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Open operations on the kidney are painful and epidural analgesia should be used where possible. refl.in/9f

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