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ding to a level above the umbilicus? Case D An intravenous pyelogram revealed that the calyces and pelvis of a patient’s right kidney were grossly dilated (a condition known as hydronephrosis). What embryological anomaly may be responsible for this condition? Case E Which congenital anomaly of the ureter is likely to present as a case of urinary incontinence? Case F operation procedure of kidney transplant nephrectomy For a nephrectomy, the kidney monly is exposed in the loin. After an oblique incision midway between the twelfth rib and the iliac crest, the posterior free border of the external oblique is identified, and divided to reveal the peritoneum, which is pushed forward to reveal the renal fascia. The subcostal nerve and vessels are preserved。 the renal fascia is opened。 and the kidney exposed. Care must be taken not to damage the pleura, since it is separated from the upper pole of the kidney only by the diaphragm.