Clipless management of the renal vein during hand-assist laparoscopic donor nephrectomy
| Autor: | Gregory S. Rosenblatt, Michael J. Conlin |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Urology Renal hilum lcsh:RC870-923 Nephrectomy Renal Veins Hand assist laparoscopic medicine Humans CLIPS Laparoscopic live donor nephrectomy computer.programming_language Intraoperative Care business.industry General Medicine Middle Aged lcsh:Diseases of the genitourinary system. Urology Tissue Donors Surgery Vascular clips medicine.anatomical_structure Reproductive Medicine cardiovascular system Renal vessels Female Laparoscopy Renal vein business computer Research Article |
| Zdroj: | BMC Urology BMC Urology, Vol 6, Iss 1, p 23 (2006) |
| ISSN: | 1471-2490 |
| Popis: | Background Laparoscopic live donor nephrectomy has become the preferred method of donor nephrectomy at many transplant centers. The laparoscopic stapling device is commonly used for division of the renal vessels. Malfunction of the stapling device can occur, and is often due to interference from previously placed clips. We report our experience with a clipless technique in which no vascular clips are placed on tributaries of the renal vein at or near the renal hilum in order to avoid laparoscopic stapling device misfires. Methods From December 20, 2002 to April 12, 2005, 50 patients underwent hand-assisted laparoscopic left donor nephrectomy (LDN) at our institution. Clipless management of the renal vein tributaries was used in all patients, and these vessels were divided using either a laparoscopic stapling device or the LigaSureTM device (Valleylab, Boulder, CO). The medical and operative records of the donors and recipients were reviewed to evaluate patient outcomes. Results The mean follow-up time was 14 months. Of the 50 LDN procedures, there were no laparoscopic stapling device malfunctions and no vascular complications. All renal allografts were functioning at the time of follow-up. Conclusion Laparoscopic stapling device failure due to deployment across previously placed surgical clips during laparoscopic live donor nephrectomy can be prevented by not placing clips on the tributaries of the renal vein. In our series, there were no vascular complications and no device misfires. We believe this clipless technique improves the safety of laparoscopic donor nephrectomy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink