Transcript
- Slide 1
- Ryan Lefevre MIS Elective UK College of Medicine April 20 th, 2011 Hand Assisted Laparoscopic Donor Nephrectomy
- Slide 2
- Anatomy
- Slide 3
- Kidney Ureter Renal Artery/Vein Iliac Vessels Abdominal Aorta Anatomy
- Slide 4
- Surgery Goals Remove Healthy Kidney for Donation Ensure Safety of Donor Patient Minimize Scarring Minimize Recovery Time
- Slide 5
- Surgery Procedures Free Colon to Visualize Kidney Free Kidney Maintain Fat on Lower Pole of Kidney Dissect Ureter to Level of Iliac Vessels Remain Medial to Gonadal Vein Clip/Separate Ureter Staple/Separate Renal Artery/Vein Remove Kidney
- Slide 6
- Procedure Notes Possible Branches Off Renal Artery Dessuflate After Dissection to Allow Kidney to Rest Administer Mannitol to Ensure Urine Production Warm Time Starts at Closure of Renal Artery
- Slide 7
- Port Placement 11mm Camera Port 12mm Working Port Hand Port
- Slide 8
- Patient Position Flexed Table Right Down Partial Flank Top ViewSide View Surgeon
- Slide 9
- Laparoscopic Instruments Ultrasonic Dissector Ligasure Clip Applier Scissors Stapler
- Slide 10
- Laparoscopic Instruments Ultrasonic Dissector Ligasure Clip Applier Scissors Stapler ethiconendosurgery.com
- Slide 11
- Laparoscopic Instruments Ultrasonic Dissector Ligasure Clip Applier Scissors Stapler ligasure.com
- Slide 12
- Laparoscopic Instruments Ultrasonic Dissector Ligasure Clip Applier Scissors Stapler covidien.com
- Slide 13
- Laparoscopic Instruments Ultrasonic Dissector Ligasure Clip Applier Scissors Stapler covidien.com
- Slide 14
- Laparoscopic Instruments Ultrasonic Dissector Ligasure Clip Applier Scissors Stapler covidien.com
- Slide 15
- Final Thoughts Work Quickly but Efficiently Especially After Start of Warm Time Ensure Donor Patient Safety Laparoscopy Can Provide a Viable Method for Donor Nephrectomy
- Slide 16
- References Dr. Strup NTC #71, University of Kentucky http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2855464/ http://www.websurg.com/ref/doi-ot02en261.htm http://www.ncbi.nlm.nih.gov/pubmed/15735385