Böbrek Naklinde Yeni Bir İnsizyon Metodu: Tek Merkez Deneyimi

Abstract

Objective: Despite such difficulties and the presence of minimally invasive techniques, open kidney transplant is still a popular method in many clinics worldwide. We tried to identify our incision for kidney transplantation, to present the anatomical limits of the incision and to discuss its advantages-disadvantages. Material and Methods: Patient selection: Ages, number of living donors-cadaver donors, anastomosis durations, operation durations, surgical incision length, surgical site circumference, post-op incisional hernia rate and presence of wound site infection were noted for the 77 patients included. Surgical Technique: After the transverse line drawn at the umbilicus level, a line connecting umbilicus and spina iliaca anterior superior (SIAS) is drawn. The center of the umbilicus-SIAS line is the lateral edge of the rectus abdominis muscle. The endpoint of our incision is 1-2 cm superior to the junction of the tuberculum pubicum with the rectus muscle. Results: Sixty nine of these kidney transplantations (89.6%) were from living and 8 were (10.3%) from cadaver donors. For transplants from a living donor, mean anastomosis duration was 31,8±7.3 min and mean operation duration was 150.6±27 min. For cadaver donors, mean anastomosis duration was 29.6±4.4 min and the mean operation duration was 137±33 min. Post-operative wound site infection was observed in 7 (9.1%) patients in 77 kidney transplantation operations. The postoperative incisional hernia was observed in 7 patients (9.1%). Conclusion: Our incision, named as renal transplantation incision, can reach the surgical site without damaging the anatomic layers and present a quite good view of the surgical site. To provide better evaluation, applications with a higher number of patients are needed.