Laparoscopic live donor nephrectomy can be performed with morbidity and mortality comparable to open donor nephrectomy, with substantial improvements in patient recovery after the laparoscopic approach. Initial graft survival and function rates are equal to those of open donor nephrectomy, but longer follow-up is necessary to confirm these observations.

The unprecedented pandemic of COVID-19 has impacted many lives and affects the whole healthcare systems globally. In addition to the considerable workload challenges, surgeons are faced with a number of uncertainties regarding their own safety, practice, and overall patient care. This guide has been drafted at short notice to advise on specific issues related to surgical service provision and the safety of minimally invasive surgery during the COVID-19 pandemic. Although laparoscopy can theoretically lead to aerosolization of blood borne viruses, there is no evidence available to confirm this is the case with COVID-19. The ultimate decision on the approach should be made after considering the proven benefits of laparoscopic techniques versus the potential theoretical risks of aerosolization. Nevertheless, erring on the side of safety would warrant treating the coronavirus as exhibiting similar aerosolization properties and all members of the OR staff should use personal protective equipment (PPE) in all surgical procedures during the pandemic regardless of known or suspected COVID status. Pneumoperitoneum should be safely evacuated via a filtration system before closure, trocar removal, specimen extraction, or conversion to open. All emergent endoscopic procedures performed during the pandemic should be considered as high risk and PPE must be used by all endoscopy staff.

Among the remarkable variety of semiconducting nanomaterials that have been discovered over the past two decades, single-walled carbon nanotubes remain uniquely well suited for applications in high-performance electronics, sensors and other technologies. The most advanced opportunities demand the ability to form perfectly aligned, horizontal arrays of purely semiconducting, chemically pristine carbon nanotubes. Here, we present strategies that offer this capability. Nanoscale thermocapillary flows in thin-film organic coatings followed by reactive ion etching serve as highly efficient means for selectively removing metallic carbon nanotubes from electronically heterogeneous aligned arrays grown on quartz substrates. The low temperatures and unusual physics associated with this process enable robust, scalable operation, with clear potential for practical use. We carry out detailed experimental and theoretical studies to reveal all of the essential attributes of the underlying thermophysical phenomena. We demonstrate use of the purified arrays in transistors that achieve mobilities exceeding 1,000 cm(2) V(-1) s(-1) and on/off switching ratios of ∼10,000 with current outputs in the milliamp range. Simple logic gates built using such devices represent the first steps toward integration into more complex circuits.

No abstract

56 Wh kg −1 ) employing ruthenium with higher cyclability have been developed, [5][6][7] but remain prohibitively expensive for wide adoption. With the availability of accurate computational tools, new approaches have leveraged carbon nanostructures and insights into the steric interaction of STFs to increase energy density employing highly cyclable and modest energy density (60-70 Wh kg −1 ) azobenzene derivatives. [ 8,9 ] While demonstrating a per-molecule increase in energy density via templating, [ 10 ] these approaches require complex multistep reactions, have low yields, and the resulting material has low solubility in most organic solvents (<1 g L −1 ). More recently, it was possible to develop liquid azobenzene fuels at room temperature by attaching bulky ligands to the molecule, [ 11 ] and with several computational works detailing the possibility of increasing its energy density through functionalization of the benzene rings, [ 12 ] this platform holds much promise for future STF developments. With such rapid progress in STF materials, it is perhaps surprising that the solid-state platform and related applications have remained largely unexplored, with only recent studies on semi-solid photoliquefi able ionic crystals reaching energy densities of 35 Wh kg −1 . [ 13 ] Transitioning fully to the solid-state offers the possibility of integrating STF materials into a multitude of existing solid-state devices such as coatings for deicing, or novel applications such as solar blankets and other consumer oriented heating equipment.We took the view that if properly engineered on the molecular level, STF materials could be controllably tailored within the solid-state, and that until now, there has not been an efficient method to accomplish this. For one, the most recent STF reports have relied on carbon scaffolds [ 10,14 ] that simultaneously increase synthesis complexity, cannot be deposited into uniform fi lms, contribute to the optical density without resulting in photocharging, and introduce uncontrollable morphological effects that may limit charging and reversible switching in the solid-state. [ 15 ] Similarly, single-molecule thin fi lms do not make homogenous layers, can often result in crystallization, and melt at low temperatures (≈70 °C for azobenzene) thus limiting their utility in the solid-state. Fortunately, a wealth of literature exists on azobenzene-based materials in solid-state applications for microswitches, microactuators, and sensors. [16][17][18][19][20][21] We postulated that the ideal material class to form solid-state STF coatings would need to (1) form smooth fi lms with controllable thickness, (2) be resilient at high temperatures, (3) preserve the heat release properties of Closed cycle systems offer an opportunity for solar energy harvesting and storage all within the same material. Photon energy is stored within the chemical conformations of molecules and is retrieved by a triggered release in the form of heat. Until now, such solar thermal fuels (STFs) have been largely unavailable...

Although laparoNx allografts have slower initial function compared with openNx, there was no significant difference in longer term renal function.

ObjectiveTo examine the ability of several large, experienced transplantation centers to perform right-sided laparoscopic donor nephrectomy safely with equivalent long-term renal allograft function. Summary Background DataEarly reports noted a higher incidence of renal vein thrombosis and eventual graft loss. However, exclusion of right-sided donors would deprive a significant proportion of donors a laparoscopically harvested graft. MethodsA retrospective review was performed among 97 patients from seven centers performing right-sided laparoscopic donor nephrectomy. Surgical and postoperative demographic factors were evaluated. Complications were identified and longterm renal allograft function was compared with historical leftsided laparoscopic donor nephrectomy cohorts. ResultsRight laparoscopic donor nephrectomy was performed for varying reasons, including multiple left renal arteries or veins, smaller right kidney, or cystic right renal mass. Mean surgical time was 235.0 Ϯ 66.7 minutes, with a mean blood loss of 139 Ϯ 165.8 mL. Conversion was required in three patients secondary to bleeding or anatomical anomalies. Mean warm ischemic time was limited at 238 Ϯ 112 seconds. Return to diet was achieved on average after 7.5 Ϯ 2.3 hours, with mean discharge at 54.6 Ϯ 22.8 hours. Two grafts were lost during the early experience of these centers to renal vein thrombosis. Both surgical and postoperative complications were limited, with few long-term adverse effects. Mean serum creatinine levels were higher than open and left laparoscopic donor nephrectomy on postoperative day 1, but at all remaining intervals the right laparoscopic donors had equivalent creatinine values. ConclusionsThese results confirm that right laparoscopic donor nephrectomy provides similar patient benefits, including early return to diet and discharge. Long-term creatinine values were no higher than in traditional open donor or left laparoscopic donor cohorts. These results establish that early concerns about high thrombosis rates are not supported by a multiinstitutional review of laparoscopic right donor nephrectomies.Laparoscopic donor nephrectomy has been a revolutionary approach used to address the increasing disparity between organ need and availability.

Laparoscopic donor nephrectomy appears to be safe and decreases morbidity in the renal donor. Allograft function is comparable to that in open nephrectomy series. The availability of laparoscopic harvesting may be increasing the living donor volunteer pool.