this video demonstrates deceased donor
kidney transplant
in a 23 year old female
a curve linear incision extending two
finger breaths above the pubic symphysis
and two finger breaths medial to the
anterior superior iliac spine
is marked on the skin
this is followed by making the skin
incision and dissection is carried to
the skin
subcutaneous tissue dissection is
continued
lateral to the lateral edge of the
rectus abdominus muscle
the hyponeurosis of the external oblique
was transected followed by transaction
of the internal oblique
the transversal muscle and the
transversal fascia
the inferior epigastric vessels were
dissected out
doubly clamped transected
and tied off with two oscillators this
was done to prevent
evolution injury to inferior epigastric
vessels while
exposing the iliac vessels in the
retroperitoneum
visualized in the base of the wound is
the peritoneum
with the peritoneal contents
adequate retraction is a key for
adequate retroperitoneal exposure for
kidney transplant
a book walter is used here as
demonstrated in the video
once adequate retraction is achieved
meticulous dissection is carried around
the iliac vessels
and both the external iliac artery and
the vein
is dissected free from the surrounding
tissue
a side biting clamp such as a satin ski
is then placed over the external iliac
vein
avenotami is then made and extended with
pot scissors
this is followed by construction of an
end-to-side anastomosis
between the external iliac vein
and the deceased donor kidney renal vein
this anastomosis is constructed using a
fibroproline suture
as demonstrated in this video
once the venous anastomosis is completed
a bulldeck clamp is then placed on the
donor
renal vein this is followed by placing a
satinsky clamp on the external iliac
artery
an arteriotomy is made in the external
area cartridge using an 11 blade
heparinized saline solution is used to
flush the artery
this is followed by construction of
an arterial anastomosis between the
donor renal artery
and the recipient's external iliac
artery
using a sexoproline suture in an
end-to-side configuration
the anastomosis is then completed
and the clamps are then released
after release of the clamps the kidney
pinked up promptly
a clamp is then placed on the foley and
the bladder is filled with saline
solution
a two centimeter incision is made
through the layers of the bladder to
reveal the bladder mucosa
seen here is the methylene blue coming
out
of the bladder the bladder mucosa
is opened
and the end of the ureter
is trimmed and spatulated
a double j stand is inserted
inside the donor's ureter and
recipient's bladder
the ureter is then an estimate
to the recipient's bladder using a 5-0
pds suture
as demonstrated in this video
once this anastomosis is completed
the muscle layers of the bladder
are reapproximated
over this anastomosis with interrupted
four opds suture
the fascia is then closed
using a running loop pds
suture the subcutaneous tissue
is then closed using a
vicryl suture followed by closure
of the skin with a photo monocle
this concludes our demonstration
on kidney transplantation
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