Browsing by Author "Papalois, Vassilios"
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Item A Fast and Safe Living-Donor "Finger-Assisted" Nephrectomy Technique: Results of 225 Cases(Başkent Üniversitesi, 2008-12) Hakim, Nadey S.; Canelo, Ruben; Papalois, VassiliosRenal transplant remains the treatment of choice for end-stage renal disease. It improves both the quality of life and the quantity of life in recipients. We present a living-donor nephrectomy technique that is less invasive than the conventional open flank incision. This technique involves only 1 incision and is smaller than the one used in the laparoscopic technique. We have successfully introduced this new technique at our center. The procedure may be done safely and is applicable in all potential donors regardless of the body mass index of the donor or the size of the surgeon’s hands. It provides excellent grafts and has allowed us to expand our living-donor program.Item Use of ETS-FLEX Endoscopic Linear Vascular Cutter in Donor Nephrectomy and Transplantation Surgery: A Single Institution’s Experience(Başkent Üniversitesi, 2004-12) Hakim, Nadey S.; Dosani, Muhammad Tariq; Papalois, VassiliosObjectives: We describe our experience with the use of ETS-FLEX endoscopic linear vascular cutter from January 2000 to October 2004 in live-donor nephrectomy and pancreatic bench work. Materials and Methods: In live-donor nephrectomy, ETS-FLEX endoscopic linear vascular cutter (ELVC) is used for the stapling and division of renal vessels and ureter. When positioned on a vessel, the vascular cutter applies 3 staple lines proximally and 3 distally, and the vessel in between them is divided. In pancreatic graft bench work, ELVC is applied in 3 steps: the splenectomy, ligation of the mesenteric root, and the ligation of any peripancreatic lymphatic tissue or small vessels. Results: From October 2000 to October 2004, we performed 80 living-donor nephrectomies in 56 men and 24 women (mean age, 39 years; range, 24-63 years). Thirty-one grafts were with multiple vessels. Mean warm ischemia time was 60 ± 5 seconds. Mean operative time was 60 ± 10 minutes. In all cases, there was no need for further hemostasis after removal of the kidney. There were no operative complications. All grafts were successfully revascularized with 100% graft survival (range of follow-up, 1-48 months). Patients’ length of stay in hospital was 3 ± 1 days. We have used the ETS-FLEX ELVC in 30 pancreatic graft preparations since January 2000. Mean time taken for the bench work preparation including Y-graft anastomosis was 45 ± 10 minutes. Following revascularization, there was excellent perfusion with minimal and easily controllable bleeding that did not require blood transfusion. Conclusions: We believe that our use of the laparoscopic instrument, ETS-FLEX ELVC, with a mini-incision technique in live-donor nephrectomy and pancreatic graft preparation makes these complex and time-consuming procedures simple and fast, minimizing the chances of postoperative complications and resulting in excellent patient and graft survival.