Document Detail

Vessel length following laparoscopic donor nephrectomy: impact of vascular ligation technique on allograft vessel length.
MedLine Citation:
PMID:  18393647     Owner:  NLM     Status:  MEDLINE    
PURPOSE: A variety of techniques have been used to secure the renal artery and vein during laparoscopic donor nephrectomy. The purpose of this study is to compare the amount of vessel length lost when the artery and vein are secured with four different techniques. METHODS: A model was constructed to simulate a left laparoscopic donor nephrectomy. In this model vessel length lost was determined when veins were secured using polymer locking (PL) clips, the endo-GIA stapling device, and the endo-TA stapling device. Arterial length lost was determined for the same three techniques, as well as securing the artery with titanium (Ti) clips. RESULTS: The mean arterial length lost for the PL clips, Ti clips, endo-TA, and endo-GIA stapling devices was 6.2, 6.3, 9.8, and 10.0 mm, respectively. Both clip types produced less loss of arterial length than both types of stapling devices (P<0.001), and there was no difference between the two types of stapling devices (P=0.73) or clips (P=0.85). The mean venous length lost for the PL clip, endo-GIA, and endo-TA stapling devices was 5.7, 10.1, and 9.4 mm, respectively. The PL clips resulted in significantly less vessel loss compared to both stapling devices (P<0.001), and there was no difference between the two stapling devices (P=0.40). CONCLUSIONS: Both types of clips resulted in longer graft arterial lengths compared to both stapling devices. PL clips resulted in longer graft vein length compared to the two stapling devices. The endo-TA stapling device was limited in this model by its inability to articulate.
Forrest C Jellison; Satyan K Shah; Joe W Mashni; Lesli I Nicolay; Okechukwu K Ojogho; D Duane Baldwin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endourology / Endourological Society     Volume:  22     ISSN:  0892-7790     ISO Abbreviation:  J. Endourol.     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-07-24     Completed Date:  2008-08-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8807503     Medline TA:  J Endourol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  973-7     Citation Subset:  IM    
Division of Urology and Transplantation, Loma Linda University Medical Center, Loma Linda, California 92354, USA.
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MeSH Terms
Hemostasis, Surgical / instrumentation*
Kidney Transplantation
Ligation / methods
Models, Biological*
Renal Artery / pathology,  surgery*
Renal Veins / pathology,  surgery*
Surgical Instruments
Surgical Staplers
Transplantation, Homologous

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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