Changes in Visceral Flow Induced by Laparoscopic and Open Living-Donor Nephrectomy: Experimental Model

Burgos, F.J.; Saenz, J.; Correa, C.; Linares, A.; Cuevas, B.; Pascual, Julio; Villafruela, J.J.; Marcén, R.; Fernández, Ana; Álvarez, Julio Galindo; Asuero, M.S.

doi:10.1016/j.transproceed.2009.06.069

Cited by 5 publications

(3 citation statements)

References 4 publications

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“…However, despite the short-term advantages, laparoscopy also has negative aspects. It has a longer learning curve [5], increases operating times and costs [2,3], and it has the disadvantages of a CO 2 pneumoperitoneum [6][7][8][9][10][11][12][13][14][15][16][17][18]. Various solutions have been proposed to overcome the consequences of CO 2 pneumoperitoneum [19][20][21][22][23][24].…”

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confidence: 99%

Optimizing working-space in laparoscopy: measuring the effect of mechanical bowel preparation in a porcine model

et al. 2013

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Background Adequate working space is a prerequisite for safe and efficient minimal access surgery. No objective data exist in literature about the effect of mechanical bowel preparation (MBP) on working space in laparoscopic surgery. We objectively measured this effect with computed tomography in a porcine laparoscopy model. Methods Using standardized anesthesia, twelve 20-kg pigs without MBP and eight 20-kg pigs with MBP were studied with computed tomography at intra-abdominal pressure (IAP) levels of 0, 5, 10, and 15 mmHg. Volumes and dimensions of the pneumoperitoneum were measured on reconstructed CT images and compared between the pigs with and those without MBP. Results A reproducible and statistically significant increase of approximately 500 ml in pneumoperitoneum volume was found in the MBP group at all levels of IAP. This represents a 43 % relative increase at a pneumoperitoneum pressure of 5 mmHg, 21 % at IAP 10 mmHg, and 18 % at IAP 15 mmHg. Peak inspiratory pressure was lower at IAP 0 and 5 mmHg in the MBP group. Anteroposterior diameter in the group with MBP was lower at 0 mmHg, but abdominal dimensions were similar in both groups at all other IAPs. This shows that the gain in working space is due to a diminished volume of the intraabdominal content and not to compression or displacement of the bowel. Conclusions MBP increases working space by reducing bowel content. Especially at low intra-abdominal working pressures, the increase in working space associated with MBP could represent an important benefit in challenging laparoscopic surgery.

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confidence: 99%

Optimizing working-space in laparoscopy: measuring the effect of mechanical bowel preparation in a porcine model

et al. 2013

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“…In a later study, Burgos et al also demonstrated that reduction in renal blood flow during LDN could be avoided by adequate peri-operative intravascular volume expansion, which in turn may reduce the incidence of orchialgia post-operatively. 11 In a further study, Gjertson and Sundaram concluded that harvesting the gonadal vein as well as the obstruction of lymphatics from the scrotal region, may further account for the incidence of post-operative ipsilateral testicular pain. 9 …”

Section: Discussionmentioning

confidence: 97%

Laparoscopic donor nephrectomy: an increasingly common cause for testicular pain and swelling

Jalali

Rahmani²,

Ad³

et al. 2012

Ann R Coll Surg Engl

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INTRODUCTIONLaparoscopic donor nephrectomy (LDN) is now a well established method for kidney procurement from living donors. In our centre, LDN is currently offered only to donors suitable for a left nephrectomy. The aim of this study was to investigate the incidence of testicular pain and swelling following LDN.METHODSA total of 25 left-sided LDN male patients were assessed in a prospective structured interview together with a control cohort of 25 male patients who had undergone left-sided open donor nephrectomy (ODN).RESULTSData were collected on testicular pain, swelling, numbness, urinary symptoms and sexual dysfunction from all 50 patients (100% response rate). Of the 25 LDN patients, 11 (44%) experienced ipsilateral testicular pain and/or swelling. In most instances, pain was of immediate onset, mild to moderate in severity, lasted for a few days to several weeks and was associated with testicular swelling (10 of 11 cases). However, testicular pain and/or swelling were not apparent in ODN patients, with only 2 of 25 (8%) experiencing mild testicular pain, 1 of whom also had swelling.CONCLUSIONSTesticular pain and swelling following LDN is a common problem. It is underreported in the literature and should be included in the differential diagnoses of testicular pain and swelling. Further investigation is required to confirm our findings.

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“…Furthermore, Ugo Pinar et al proposed avoiding tissue incision around the gonadal vein to minimize neural fiber damage [ 9 ]. Burgos et al indicated that appropriate perioperative intravascular volume expansion could prevent a drop in renal blood flow during LDN, which may decrease the likelihood of orchialgia postoperatively [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Post-Laparoendoscopic Single-Site Donor Nephrectomy Ipsilateral Testicular Pain, Does Operative Technique Matter? A Single Center Experience and Review of Literature

Hennawy

Faifi

Atta

et al. 2022

Minimally Invasive Surgery

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Aim. To assess incidence and characteristics of post-laparoendoscopic single-site donor nephrectomy (LESS DN) testicular pain. Materials and Methods. A prospective comparative study of all male donors post-left LESS DN (group A) vs. postopen nephrectomies (group B) was performed at our center. Patients’ demographics, perioperative data, and postoperative consultation reports were reviewed. Testicular pain, swelling, numbness, urinary symptoms, and sexual dysfunction were evaluated. Patients with a history of scrotal pathology or surgical procedure were excluded. Pain and tenderness were scored on a standard 10-point scale. Results. From September 2017 to December 2020, 85 and 35 male patients of groups A and B met the evaluation criteria. Ipsilateral testicular pain developed in 11 patients (15.3%) and 2 patients (9.5%) in groups A and B, respectively. In most instances, the pain was mild to moderate in severity, started after 6 ± 2.1 and 4 ± 1.1 days postoperatively in groups A and B, respectively. Six patients in group A were evaluated with transscrotal ultrasonography that showed no abnormalities. All patients in both groups responded well to medical treatment. Conclusions. Post-LESS DN ipsilateral testicular pain is usually mild and self-limited. Preoperative patient education and discussion of the possibility of development of testicular pain and its management should be an integral component of laparoscopic donor nephrectomy informed consent.

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Changes in Visceral Flow Induced by Laparoscopic and Open Living-Donor Nephrectomy: Experimental Model

Cited by 5 publications

References 4 publications

Optimizing working-space in laparoscopy: measuring the effect of mechanical bowel preparation in a porcine model

Optimizing working-space in laparoscopy: measuring the effect of mechanical bowel preparation in a porcine model

Laparoscopic donor nephrectomy: an increasingly common cause for testicular pain and swelling

Post-Laparoendoscopic Single-Site Donor Nephrectomy Ipsilateral Testicular Pain, Does Operative Technique Matter? A Single Center Experience and Review of Literature

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