Qian Zhang, MD, PhD

As part of Grand Rounds in Urology’s ongoing series highlighting urologists working in Asia, Qian Zhang, MD, PhD, Professor and Vice Director in the Department of Urology at Peking University First Hospital in Peking, China, presents surgical tips and tricks for performing retroperitoneoscopic kidney surgery. After an introduction by Peter K.F. Chiu, MD, PhD, FRCSEd, Associate Professor of Urology at the S.H. Ho Urology Centre of the Chinese University of Hong Kong, Prof. Qian goes over the advantages of the retroperitoneal versus the transperitoneal approach, highlighting the shorter operation time, the ability to directly control the renal artery, and the lack of gastrointestinal interference. He also discusses some improvements to patient positioning, including placing the patient’s head as far forward as possible while placing their hip as far back as possible. Dr. Qian then looks at trocar placement and considers the importance of practicing 6 basic surgical skills, including cut, twist, rip, open up, pull, and push. He summarizes the 3-step and 2-step methods of needle adjustment, and then follows this by showing videos demonstrating his 6-step partial nephrectomy technique. The 6 steps include: (1) open fascia; (2) find tumor; (3) artery dissection; (4) tumor resection; (5) surface suture; and (6) unblock artery. Dr. Qian also shares some tips and tricks, focusing on his blocking method. The presentation concludes with a question and answer session led by Dr. Chiu.