V-013 NEW TECHNIQUE FOR ABDOMINAL WALL GRAFT RETRIEVAL

Abstract

Abstract Aim show our technique for abdominal wall graft retrieval minimizing warm ischemia time. Material and methods a video report of an abdominal wall graft retrieval (full-thickness) from a female brain death donor. Results better graft perfusion with a lower picnosis in the studied cells. Lower tissue damage in both full-thickness and isolated fascia grafts. Surgical technique: An “house-flap” incision is done as opposed to a conventional cross-line laparotomy. The flap is extended until the inguinal ligament, divided afterwards to gain easier access to the femoral vessels. After abdominal organ dissection, the common iliac arteries are dissected from close to the aortic bifurcation up to the femoral vessels, beyond the origin of the inferior epigastric arteries. After cannulation of the aorta, cava vein and inferior mesenteric vein for the intraabdominal organs, both common iliac arteries are cannulated beyond the origin of external iliac artery. To achieve optimal perfusion of the rectus fascia we have to clamp the artery distal to the origin of the inferior epigastric artery (usually at the level of the femoral artery). The abdominal wall graft perfusion is done simultaneously with all the abdominal organs. Afterwards, we cover the graft with cold pads to avoid direct contact between the ice and the graft. A closure of the donor abdominal wall must be ensured after removing the wall graft. Conclusions our technique has showed better pathological outcomes than those previously published with a lower warm ischemia time of the abdominal wall graft.