Renal artery clip dislodgement during hand-assisted laparoscopic living donor nephrectomy.
Surg Endosc
; 17(11): 1851, 2003 Nov.
Article
en En
| MEDLINE
| ID: mdl-14959737
The main reason for conversion in laparoscopic donor nephrectomy (LDN) is peroperative bleeding. One of the advantages of hand-assisted laparoscopic donor nephrectomy (HDLN) is facilitated control in case of bleeding. This report describes two methods to avert conversion in HLDN in the case of abrupt major arterial bleeding. In the first case, during left HLDN the clips placed on the renal artery dislodged, and the surgeon managed to control the bleeding by compressing the focus of the bleeding with his finger. A balloon occlusion catheter was inserted through a groin incision in the aorta and advanced to the origo of the renal artery. Due to control of the hemorrhage, it was possible to close the renal artery stump by laparoscopic suturing, and a conversion was averted. The patient was discharged after 5 days, without signs of damage to the remaining kidney. In the second case, during right HLDN, the clips on the renal artery dislodged during stapling of the renal vein. The bleeding was controlled by finger compression and new clips were placed. The cuff of the artery was long enough to be clipped again. The patient was discharged after 5 days. Graft function was excellent in both cases. Major arterial bleeding can be controlled and managed in hand-assisted laparoscopic surgery. The use of a balloon occlusion catheter is an elegant way to avert conversion.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Arteria Renal
/
Instrumentos Quirúrgicos
/
Pérdida de Sangre Quirúrgica
/
Laparoscopía
/
Donadores Vivos
/
Recolección de Tejidos y Órganos
/
Hemostasis Quirúrgica
/
Nefrectomía
Tipo de estudio:
Etiology_studies
Límite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Surg Endosc
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
/
GASTROENTEROLOGIA
Año:
2003
Tipo del documento:
Article
País de afiliación:
Países Bajos
Pais de publicación:
Alemania