Recipient procedure
- Endotracheal intubation for GA
- Establishment of arterial line & CVP monitoring access
- Pt. is placed in supine position
- Oblique Rutherford-Morrison incision
- Ext.oblique, Int.oblique, Transversus abd. muscles divided
- Inferior epigastric vessels ligated & divided
- Spermatic cord freed & retracted (round ligament can be divided)
- Peritoneum pushed medially& upwards
- Common , Ext.iliac, Int.iliac arteries mobilized
- Ext. iliac vein mobilized
- Para psoas gutter developed for final placing of kidney
- Vascular clamps applied to Ext/int.iliac artery & Ext.iliac vein
- Venotomy & arterotomy are given
Back table work for vascular variations
Vascular anastomosis
Renal artery to Ext.iliac artery
End
to side fashion with 5-0 or 6-0 prolene
( in End to End fashion if Int.iliac artery is
selected )
Renal vein to Ext.iliac vein
side to side fashion
with 5-0 or 6-0 prolene
Kinks and twists are avoided during vascular anastomosis
Reconstruction of urinary tract
- Orientation of renal vein, artery & pelvis is reversed antero-posteriorly when opposite iliac fossa is selected
- Uretero neocystostomy is done in Lich-Gregoir’s extra vesical technique with 3-0 or 4-0 synthetic absorbable suture material like polyglactide or polydioxanone
- Placement of Double J stent is optional
- Wound is closed in layers after fashioning a drain
Patient in supine position
Foley’ catheter placed
Double J stent and Ureteral Stent used in removing tumors either from ureter or the kidney. Manish Medi is a leading manufacturers of Double J stent and Ureteral Stent with high quality technology
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