Surgical aspects of clinical renal transplantation

Abstract

413with an anterior repair which, in turn, will reduce the risk of a direct recurrence.It is now 80 years since Bassini (1888) first described his operation and founded a principle of repair which, but for its ease of execution and the adaptability of nature, would have been abandoned years ago. If the problem of inguinal hernia is to be solved, we must seek a new principle of repair rather than yet another variant of the posterior repair operation. The operation I propose takes no longer to perform than the standard Bassini and gives uniformly good results with no complications-a finding by no means unique in the annals of the inguinal hernia. It is therefore my sincerest wish that the operation will be given as wide a trial as possible in the hope that it may one day be submitted to the acid test of impersonal statistical review, for no operation can be considered of value which cannot achieve success in the hands of all who wish to use it.

Ureteral Complications in Human Renal Transplantation

“…[13] encountered ureteral obstruction caused by kinks close to the bladder in 2 among 70 UV anastomoses: both were corrected by surgical intervention. With our technique, we have not experienced any of the above-mentioned complications.…”

Renal Allograft Rupture: a Report of Three Cases and Review of the Literature

“…Fre quency of allograft rupture is probably higher than is gen erally recognized, as graft rupture may go undetected in some patients. One of the ruptures described by Salaman et al [34] was found incidentally at the time an operation was performed because of continuing anuria on the 22nd day posttransplantation. Graft rupture usually occurs within the first 2 weeks of transplantation ( fig.…”

“…It was suggested by Moor [27] that routine capsulotomy might prevent rupture, as he had not seen any case of rupture in their 138 renal transplantations in which routine capsulotomy was done. Since the allografts at the time of exploration were swollen and edematous, some authors have practiced prophylactic capsulotomy in an attempt to reduce the incidence of rupture [34], Unfortunately, rupture has occurred despite capsulotomy [16,34,40]. Salaman et al [34] reported 3 cases of rup ture in 74 renal allograft implantations in which capsulo tomy was performed and also observed 15 serious epi sodes of bleeding attributable to capsulotomy.…”

“…Therefore, it is difficult to recommend capsulotomy as preventive mea sure to minimize the likelihood of allograft rupture. Mur ray et al [28] and Salaman et al [34] felt that renal biopsy was a major factor contributing to renal allograft rupture in 2 cases, however, in the other cases, the biopsy site was not the site of rupture. Monies et al [26] did capsulotomy and biopsy in all of their patients at the time of transplant, but did not mention whether the biopsy site was involved in rupture or not.…”

Urological Complications in Renal Transplantation

“…The importance of the preservation of this vascular supply when removing a donor kidney cannot be overemphasized. Undue haste must be avoided (4,(45)(46)(47), and the kidney is removed en bloc with a !arge conical mass of hilar and periureteric fatty tissue without dissection being performed at the renal hilum or pelvis (4,47).…”