Final answer:
For a nephrectomy to remove a tumor in the upper pole of the left kidney, a subcostal incision is typically used, as it provides optimal exposure and minimizes muscle cutting.
Step-by-step explanation:
The incision used for a nephrectomy, which is the surgical removal of a kidney, depends on several factors, including the specific location of the tumor and the patient's anatomy. For Ms. Tovar, who requires a nephrectomy to remove a tumor in the upper pole of the left kidney, a subcostal incision (Option 3) is typically the most appropriate. This incision offers excellent exposure to the upper pole of the kidney and minimizes muscle cutting.
The kidneys are retroperitoneal organs located at the vertebral level T12 to L3, and their upper parts are somewhat protected by the eleventh and twelfth ribs. The presence of perirenal and pararenal fat, as well as the renal fascia, provides additional protection and cushioning to these organs. In the case of renal surgery, a subcostal incision follows the line of the 12th rib, offering direct access to the kidney without needing to navigate the peritoneum.