Laparoscopic Surgery for Kidney Orthotopic Transplant in the Pig Model

He, Bulang; Musk, Gabby C.; Mou, Lingjun; Waneck, Gerald L.; Delrivière, Luc

doi:10.4293/108680812x13517013318021

Cited by 17 publications

(9 citation statements)

References 18 publications

(15 reference statements)

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“…It is also important to stress that such concerns about robotic methods are based on a small number of scientific analyses and are greatly influenced by negative feedback from the US Food and Drug Administration (FDA) and the MAUDE (Manufacturer and User Facility Device Experience) database. These are largely concerned with the functioning of da VINCI in different surgical specialties and are not backed up by sufficient data [ 64 – 67 ]. In contrast, over 700 successful donor nephrectomies have been performed to date as well as more than 70 renal transplants, which have contributed to a reduced number of infections and other side risk factors correlated with standard open renal replacement.…”

Section: The Development Of Surgical Methodsmentioning

confidence: 99%

Novel surgical techniques, regenerative medicine, tissue engineering and innovative immunosuppression in kidney transplantation

Nowacki¹,

Nazarewski²,

Kloskowski³

et al. 2016

aoms

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On the 60th anniversary of the first successfully performed renal transplantation, we summarize the historical, current and potential future status of kidney transplantation. We discuss three different aspects with a potential significant influence on kidney transplantation progress: the development of surgical techniques, the influence of regenerative medicine and tissue engineering, and changes in immunosuppression. We evaluate the standard open surgical procedures with modern techniques and compare them to less invasive videoscopic as well as robotic techniques. The role of tissue engineering and regenerative medicine as a potential method for future kidney regeneration or replacement and the interesting search for novel solutions in the field of immunosuppression will be discussed. After 60 years since the first successfully performed kidney transplantation, we can conclude that the greatest achievements are associated with the development of surgical techniques and with planned systemic immunosuppression.

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Section: The Development Of Surgical Methodsmentioning

confidence: 99%

Novel surgical techniques, regenerative medicine, tissue engineering and innovative immunosuppression in kidney transplantation

Nowacki¹,

Nazarewski²,

Kloskowski³

et al. 2016

aoms

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“…Female pigs are commonly utilized as an animal model for biomedical research and a urethral catheter is placed for a range of reasons: measurement of intra-abdominal pressure; 1 placement of pressure sensors in the urinary bladder wall; 2 serial urine sampling; 3 cystoscopy; 4 to cause injury to the urethral sphincter; 5 and intra-operative measurement of urine output and bladder drainage. 6–8…”

mentioning

confidence: 99%

“…Female pigs are commonly utilized as an animal model for biomedical research and a urethral catheter is placed for a range of reasons: measurement of intraabdominal pressure; 1 placement of pressure sensors in the urinary bladder wall; 2 serial urine sampling; 3 cystoscopy; 4 to cause injury to the urethral sphincter; 5 and intra-operative measurement of urine output and bladder drainage. [6][7][8] The procedure for insertion of a urinary catheter is not usually described in any detail in scientific publications. In one publication the sows were conscious for placement of the catheter 3 but it is more common that the pigs are anaesthetized.…”

mentioning

confidence: 99%

Catheterization of the urethra in female pigs

Musk

Zwierzchoniewska

2015

Lab Anim

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Female pigs are commonly utilized as an animal model for biomedical research and require urethral catheterization. Sixteen pigs were anaesthetized for research purposes and required the placement of a urethral catheter. Post-mortem examination of the vaginas revealed the urethral opening to be consistently halfway from the mucocutaneous junction of the vulva to the cervix. A shallow diverticulum was also observed on the ventral floor of the urethral opening. To optimize conditions for success the pig should be carefully positioned supine, a vaginal speculum and light source should be used, the pig should be adequately anaesthetized, and the anatomy of the vagina should be reviewed.

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“…The “quiet needle holder” technique and the 2.8-mm laparoscopic instruments, as well as beltization of the grafts vein facilitating anastomoses for vessel anastomoses were also important factors for the success of laparoscopic-combined pancreas and kidney transplantation. Laparoscopic orthotopic kidney transplantation was reported to be feasible in animal experiments [9,10,17]. Thus far, there have been no experiences of laparoscopic pancreas transplantation reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of Laparoscopic Combined Para-Orthotopic Pancreas and Orthotopic Kidney Transplantation: Initial Research with a Pig Model

Han

Zhao

et al. 2018

Ann Transplant

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BackgroundThe aim of this study was to investigate the feasibility of laparoscopic combined para-orthotopic pancreas and orthotopic kidney transplantation in a pig model.Material/MethodsTwelve white female pigs, (4–5 months old, weight range 40–45 kg) were used as donors and recipients, and 6 laparoscopic-combined pancreas and kidney transplantations were performed. After bilateral nephrectomy, the pancreatic artery and vein were anastomosed to the right renal artery and vein, respectively, and the pancreatic fluid was diverted to the duodenum or jejunum. The renal artery and vein were anastomosed to the left renal artery and vein, respectively. The ureter (or kidney pelvis) was anastomosed to the left native ureter (or kidney pelvis). The data of the operations were recorded, and grafts were inspected at autopsy.ResultsFour of the 6 recipient pigs underwent the entire procedure. The duodenum-to-duodenum anastomosis was unfinished in 1 case, and both the duodenum-to-duodenum and renal pelvis-to-pelvis anastomoses were left unperformed in another case. The mean recipient operative time was 429±43 minutes. The mean venous and arterial anastomotic times were 69±15 minutes and 37±18 minutes, respectively, for pancreas transplantation and 56±09 minutes and 42±06 minutes, respectively, for kidney transplantation. The time for renal pelvis-to-pelvis anastomosis was 56±13 minutes and for duodenum-to-duodenum anastomosis was 90±13 minutes. The mean blood loss for recipient pigs was 98±35 mL. An immediate viable blood supply was seen in the 4 pancreatic grafts and in the 5 kidney grafts during the operation by the appearance of a bright red color after revascularization. Five pancreatic grafts had autopsy-proven reliable artery anastomoses and 4 reliable vein anastomoses. All 6 kidney grafts had autopsy-proven reliable artery anastomoses; however, 1 had a vein anastomotic stricture.ConclusionsOur study showed that laparoscopic-combined para-orthotopic pancreas and orthotopic kidney transplantation in pigs is surgically possible.

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Laparoscopic Surgery for Kidney Orthotopic Transplant in the Pig Model

Abstract: The authors report that a laparoscopic technique could facilitate orthotopic kidney transplantation in selected patients.

Cited by 17 publications

References 18 publications

Novel surgical techniques, regenerative medicine, tissue engineering and innovative immunosuppression in kidney transplantation

Novel surgical techniques, regenerative medicine, tissue engineering and innovative immunosuppression in kidney transplantation

Catheterization of the urethra in female pigs

Feasibility of Laparoscopic Combined Para-Orthotopic Pancreas and Orthotopic Kidney Transplantation: Initial Research with a Pig Model

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