Deviceless Low-Pressure Operation; A Cost-Effective Way to Reduce CO2 -Induced Barotrauma During Hand-Assisted Laparoscopic Donor Nephrectomy

Abstract Between March 2008 and March 2011, hand-assisted laparoscopic donor nephrectomles were performed on 70 patients. Following the first 26 cases undertaken based on guidelines in the literature, we modified the procedure to avoid barotrauma to the kidney caused by the usual 12–13 mm Hg CO2 pne...

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Bibliographic Details
Published inTransplantation proceedings Vol. 44; no. 7; pp. 2136 - 2138
Main Authors Kovacs, J.B, Branstetter, G, Piros, L, Deak, P.A
Format Journal Article Conference Proceeding
LanguageEnglish
Published Amsterdam Elsevier Inc 01.09.2012
Elsevier
Subjects
Adult
Aged
Barotrauma - chemically induced
Barotrauma - prevention & control
Biological and medical sciences
Carbon Dioxide - adverse effects
Cost-Benefit Analysis
Digestive system. Abdomen
Endoscopy
Female
Fundamental and applied biological sciences. Psychology
Fundamental immunology
Hand
Humans
Investigative techniques, diagnostic techniques (general aspects)
Laparoscopy - methods
Male
Medical sciences
Middle Aged
Nephrectomy - methods
Pressure
Surgery
Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases
Surgery of the urinary system
Tissue Donors
Tissue, organ and graft immunology
Endoscopic surgery
Living donor
Carbon dioxide
Hand assisted laparoscopic surgery
Laparoscopy
Transplantation
Operation
Trauma
Pressure
Kidney
Medicine
Treatment
Urinary system
Nephrectomy
Low
Graft
Endoscopy
Organ harvesting
Cost efficiency analysis
Barotrauma
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Summary:Abstract Between March 2008 and March 2011, hand-assisted laparoscopic donor nephrectomles were performed on 70 patients. Following the first 26 cases undertaken based on guidelines in the literature, we modified the procedure to avoid barotrauma to the kidney caused by the usual 12–13 mm Hg CO2 pneumoperitoneum or pneumoretroperitoneum. The perirenal CO2 pressure, therefore, was decreased to 8 mm Hg from the beginning of the surgery; the operation was performed without using a handport. Our early experience with the modified technique suggested that the safety and duration of the procedure were not affected but the incidence of delayed graft function due to barotrauma was decreased, a cost-effective improvement.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2012.07.100