Obtaining Cuff of Inferior Vena Cava by Use of the Endo-TA Stapler in Retroperitoneoscopic Right-Side Donor Nephrectomy

Modi, Pranjal; Kadam, Gaurang; Devra, Amit Kumar

doi:10.1016/j.urology.2007.01.031

Cited by 25 publications

(15 citation statements)

References 16 publications

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“…Many techniques have been used to secure the renal artery and vein during laparoscopic nephrectomy (like Hem-o-lock clips, titanium clips or Vascular Stapler) [14][15][16], but ligation and division of the renal hilum are critical steps during any procedure with any techniques of vascular control for the risks of serious complications [17,18]. EndoGIA staplers are widely used to manage vessels in laparoscopic nephrectomy because of their feasibility and safety and their use has become standard practice [19][20][21].…”

Section: Discussionmentioning

confidence: 99%

Bleeding Control and Vascular Preservation in Laparoscopic Living Donor Nephrectomy. Powered vs. Mechanical Vascular Stapler: A Possible Real Advantage

Gl¹,

Baccarani²,

Cherchi³

et al. 2017

J Kidney

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Kidney transplantation (KTx) is the treatment of choice for end stage renal disease (ESRD), improving both quality, and quantity of life in the recipients. Living Donor Kidney Transplantation (LDKT) is both related to a longer patient and graft survival, and laparoscopic donor nephrectomy (LDN) is the procedure of choice by most transplants Centers. Even though many techniques have been used to secure both the renal artery and vein during laparoscopic nephrectomy (Hem-o-lock clips, titanium clips or Vascular Stapler), ligation and division of the renal hilum remain two critical steps, entailing a certain risk of serious complications. Mechanical EndoGIA vs. iDrive ™ Ultra Powered Stapling System (Autosuture; Covidien Surgical, Mansfield) have been compared. iDrive ™ is a reusable, handled stapler computer-controlled stapling systems that runs on battery and can be used on multiplepatients. It comprises a hand-held control unit, and a loading unit, which consists in a powered EndoGIA cartridge. We evaluated safety, efficacy, maneuverability and ergonomics for renal vascular control during LDN. Moreover, the differences in costs between the two procedures were also analyzed. There were no malfunctions or complications related to the use of iDrive ™ requiring conversion to open procedure. Advantages in maneuverability and costs were also observed. The total timing related to the use of the devices was statistically significant shorter for the iDrive ™ than for the EndoGIA being respectively 3.4 ± 0.4 minutes vs. 4.2 ± 0.4 minutes (p=0.0014). In our experience, iDrive ™ is safe and feasible for separate ligation and accurate division of renal artery and vein during LDN. The system also helps to minimize the need for additional maneuvers to secure the renal hilum. Furthermore, it allows greater precision of cutting on the kidney vessels that will have to be used for transplantation.

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Section: Discussionmentioning

confidence: 99%

Bleeding Control and Vascular Preservation in Laparoscopic Living Donor Nephrectomy. Powered vs. Mechanical Vascular Stapler: A Possible Real Advantage

Gl¹,

Baccarani²,

Cherchi³

et al. 2017

J Kidney

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“…73 It has been widely used in Japan, India, and China. [14][15][16][17] In view of the kidney's anatomy, this approach provides quick access to the renal artery and renal vein. The ureter is usually visualized after establishing the workspace.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, this approach is favored in dealing with lumbar veins as it allows direct visualization during donor nephrectomy. [15][16][17] Therefore, the risk of vessel injury during donor nephrectomy is less when using the RA.…”

Section: Discussionmentioning

confidence: 99%

Untitled

Bremner²,

Han³

et al. 2016

Exp Clin Transplant

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Objectives: Laparoscopic living-donor nephrectomy is now widely used because of its many beneficial features. Currently, there are 2 major techniques: the laparoscopic intraperitoneal approach and the retroperitoneoscopic approach. There is no evidence to support one particular approach over another. Therefore, in this study, we conducted a systematic literature review with the aim of defining which technique is superior. Materials and Methods: The Embase, PubMed, and Cochrane literature databases were searched for English language articles published between January 1994 and January 2013 using the terms "laparoscopic donor nephrectomy," "retroperitoneoscopic donor nephrectomy," and "live donor nephrectomy." A metaanalysis was undertaken, and I 2 statistical analyses were used to describe the percentage of variation across studies due to heterogeneity rather than chance. Results: With the use of our selection criteria, 55 papers on the laparoscopic intraperitoneal approach and 6 papers on the retroperitoneoscopic approach were included in this study. We found significantly lower transfusion rate, fewer patients with delayed graft functions, less vessel injuries, and less conversion to open surgical procedure with the retroperitoneoscopic approach than with the laparoscopic intraperitoneal approach. Conclusions: From this review, a high degree of study heterogeneity was identified, suggesting an urgent need for consistency in reporting laparoscopic livingdonor nephrectomy. Results of the meta-analyses may define a better technique for the future. The retroperitoneoscopic approach may be better than the laparoscopic intraperitoneal approach with fewer complications and fewer patients with delayed graft function. Further study of laparoscopic living-donor nephrectomy is recommended to define a standard and thus to minimize the surgical morbidities.

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“…Several novel techniques have been proposed to maximize renal vein length while maintaining the laparoscopic approach: the use of modified staplers; excision of an inferior vena caval cuff with the donor vessel; using a hand-assisted approach to allow for improved traction; and inverting the kidney during the anastomosis, all without compromising immediate or long-term graft function. [26][27][28][29] Overall, long-term graft survival for open and laparoscopic donor nephrectomy is equivalent. 20,30,31 This finding supports the superiority of the minimally invasive approach over open donor nephrectomy.…”

Section: Unsurprisingly Led To Donationmentioning

confidence: 99%

Live donor nephrectomy for kidney transplantation

Şener

Cooper

2008

Nat Rev Urol

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The number of patients with end-stage renal disease is increasing substantially every year around the world. Renal transplantation is the best treatment option to improve survival and quality of life. Although the numbers of living, related and deceased transplant donors has also increased, this growth is insufficient to keep up with the expansion rate of the renal failure population. The introduction of laparoscopic donor nephrectomy has gained widespread acceptance by physicians and patients, and seems to be better than open donor nephrectomy in terms of reduced postoperative pain, quick recovery and improved cosmetic outcomes. Evidence strongly suggests that graft survival is similar in recipients of kidneys from living related and unrelated donors. Fortunately, this information has raised awareness of the suitability of potential live, unrelated donors, including spouses, friends, or even anonymous donors. In this Review we touch on sociological aspects of living related kidney transplantation and review the available and proposed methods of increasing the live donor pool, including organ exchange and desensitization protocols for ABO-incompatible and cross-match-positive donor pairs.

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Obtaining Cuff of Inferior Vena Cava by Use of the Endo-TA Stapler in Retroperitoneoscopic Right-Side Donor Nephrectomy

Cited by 25 publications

References 16 publications

Bleeding Control and Vascular Preservation in Laparoscopic Living Donor Nephrectomy. Powered vs. Mechanical Vascular Stapler: A Possible Real Advantage

Bleeding Control and Vascular Preservation in Laparoscopic Living Donor Nephrectomy. Powered vs. Mechanical Vascular Stapler: A Possible Real Advantage

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Live donor nephrectomy for kidney transplantation

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