Background.
The benefits of minimal invasive donor hepatectomy, especially for left lateral sectionectomy (LLS) have been unequivocally demonstrated. Moreover, donors in pediatric liver transplantation (LT) are usually parents who need to recover quickly to take care of the child. There are inherent limitations to conventional laparoscopic surgery including surgeon’s experience with advanced laparoscopic surgery and steep learning curve which limits the wide application of minimal invasive donor hepatectomy. We share our experience of establishing a program of robotic donor hepatectomy (RDH) and achieving proficiency in performing RDH for pediatric LT.
Methods.
Data were prospectively collected of consecutive LLS RDH based on a structured learning algorithm. Donor and recipient outcomes were analyzed.
Results.
Seventy-five consecutive cases of LLS RDH were performed. The median primary warm ischemia time was 6 min (interquartile range [IQR]: 5–7 min). No major complications (grade ≥IIIb Clavien-Dindo) were noted in the cohort. There were no emergency conversion to open surgery and neither were there postoperative explorations through a laparotomy. Seven grafts were hyper-reduced and 5 required venoplasty. Two recipients died because of severe sepsis and multiorgan failure. Major complications occurred in 15 children (20%), none of which were attributable to RDH. Median hospital stay of the donors and recipients was 5 d (IQR: 5–6) and 12 d (IQR: 10–18) respectively.
Conclusions.
We share our experience of starting a RDH program for pediatric LT. We highlight the challenges and our learning algorithm to spur teams on the cusp of starting robotic transplant programs.
With a higher energy demand, the cost of oil is also increasing along with that the resources are vanishing at a very high pace and such conventional fuels creates environmental pollution, thus the best option is to find some clean, viable alternative for the same. Biodiesel is an available option and thus a better substitute for the IC engine fuel, It majorly restricts high emissions of the Carbon Monoxide(CO), Particulate Matter (PM), Hydrocarbon (HC) emission. Perversely, a number of experiments are conducted on a single blended bio fuel. This paper concentrates on two different bio-fuel blends with diesel. Calophylum Inophylum oil used for controlling the emission from the exhaust and subsequently improves the performance of an engine. The parameters are as follow: Brake thermal efficiency (BTE), specific fuel consumption and exhaust emission were noted. Lower the blends of biofuel more will be the thermal efficiency and thus it too reduces the specific fuel consumption. Calophylum Inophylum oil is used to prepare biodiesel blends ie (B20 and B40). The combustion characteristics investigated are cylinder gas pressure and heat release rate. Investigation is carried out at various loads and varying crank angles. The emissions at exhaust end were decreased while an increase was noted when the parts of biodiesel in the blend formed. This itself is sufficient to prove the viability and potential of the biofuel as an alternative to the conventional fuel being used to run an IC engine.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.