Successful Use of Ectopic Pelvic Kidney for Living Related Donation Technical Aspects and Literature Review

Ectopic pelvic kidneys can provide an additional source of organs for transplantation. They are often excluded from donation in living donation programs mainly due to aberrant vascular and urinary anatomies. We present a donor with an ectopic left kidney, who successfully donated his kidney. The use of ectopic pelvic kidney for living kidney transplantation is a highly demanding surgical procedure but after extensive preoperative investigation in high volume centers with surgical expertise in vascular reconstruction and access surgery, ectopic pelvic kidneys should not be a contraindication for donation and should be considered as a viable option.

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Vascular Involvements in Cholangiocarcinoma: Tips and Tricks

Cancers ◽

10.3390/cancers13153735 ◽

2021 ◽

Vol 13 (15) ◽

pp. 3735

Author(s):

Roberta Angelico ◽

Bruno Sensi ◽

Alessandro Parente ◽

Leandro Siragusa ◽

Carlo Gazia ◽

...

Keyword(s):

Portal Vein ◽

Hepatic Artery ◽

Vena Cava ◽

High Volume ◽

Vascular Reconstruction ◽

Ex Situ ◽

Vascular Involvement ◽

Hepatic Veins ◽

Hepatic Artery Resection ◽

Artery Resection

Cholangiocarcinoma (CCA) is an aggressive malignancy of the biliary tract. To date, surgical treatment remains the only hope for definitive cure of CCA patients. Involvement of major vascular structures was traditionally considered a contraindication for resection. Nowadays, selected cases of CCA with vascular involvement can be successfully approached. Intrahepatic CCA often involves the major hepatic veins or the inferior vena cava and might necessitate complete vascular exclusion, in situ hypothermic perfusion, ex situ surgery and reconstruction with autologous, heterologous or synthetic grafts. Hilar CCA more frequently involves the portal vein and hepatic artery. Resection and reconstruction of the portal vein is now considered a relatively safe and beneficial technique, and it is accepted as a standard option either with direct anastomosis or jump grafts. However, hepatic artery resection remains controversial; despite accumulating positive reports, the procedure remains technically challenging with increased rates of morbidity. When arterial reconstruction is not possible, arterio-portal shunting may offer salvage, while sometimes an efficient collateral system could bypass the need for arterial reconstructions. Keys to achieve success are represented by accurate selection of patients in high-volume referral centres, adequate technical skills and eclectic knowledge of the various possibilities for vascular reconstruction.

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Living-Related Transplantation of an Ectopic Pelvic Kidney.

Transplantation Journal ◽

10.1097/01.tp.0000115649.87806.7b ◽

2004 ◽

Vol 77 (6) ◽

pp. 803 ◽

Cited By ~ 2

Author(s):

Otto B. Stroosma ◽

Marc R. M. Scheltinga

Keyword(s):

Pelvic Kidney ◽

Living Related

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Training vascular access surgeons: technicians or specialists?

The Journal of Vascular Access ◽

10.5301/jva.5000824 ◽

2018 ◽

Vol 19 (2) ◽

pp. 117-118

Author(s):

Nicholas Inston ◽

Tej M. Singh

Keyword(s):

Surgical Training ◽

Vascular Access ◽

Vascular Access Surgery ◽

Technical Aspects ◽

Knowledge And Skills ◽

Traditional Training ◽

Access Surgery ◽

Future Practice ◽

And Training

Internationally, vascular access (VA) surgery is delivered in a varied and diverse fashion and subsequently, training in vascular access is poorly defined. Experience of VA during surgical training has implications on future practice. The scope of VA procedures is increasing, yet the focus in vascular training remains largely in the technical aspects of surgery rather than the more comprehensive aspects of surgery applied to dialysis and renal care. To achieve special skills in vascular access surgery may require a change to traditional training with an additional focus on developing an extended portfolio of knowledge and skills. A small number of specialized courses and training facilities are developing to address these issues.

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Long-term Results of Enterprise Stent-Assisted Coiling of Cerebral Aneurysms

Neurosurgery ◽

10.1227/neu.0b013e3182571953 ◽

2012 ◽

Vol 71 (2) ◽

pp. 239-244 ◽

Cited By ~ 111

Author(s):

Kyle M. Fargen ◽

Brian L. Hoh ◽

Babu G. Welch ◽

G. Lee Pride ◽

Giuseppe Lanzino ◽

...

Keyword(s):

Scale Score ◽

Cerebral Aneurysms ◽

High Volume ◽

Vascular Reconstruction ◽

Long Term Results ◽

Modified Rankin Scale ◽

Volume Data ◽

Stent System

Abstract BACKGROUND: The Enterprise Vascular Reconstruction Device and Delivery System (Cordis; the Enterprise stent) was approved for use in conjunction with coiling of wide-necked aneurysms in 2007. No published long-term aneurysm occlusion or complication data exist for the Enterprise system. OBJECTIVE: We compiled data on consecutive patients treated with Enterprise stent-assisted coiling of aneurysms from 9 high-volume neurointerventional centers. METHODS: A 9 center registry was created to evaluate large volume data on the delayed safety and efficacy of the Enterprise stent system. Pooled data were compiled for consecutive patients undergoing Enterprise stent-assisted coiling at each institution prior to May 2009. RESULTS: Two-hundred twenty-nine patients with 229 aneurysms, 32 of which were ruptured aneurysms, were included in the study. Mean clinical and angiographic follow-up was 619.6 ± 26.4 days and 655.7 ± 25.2 days, respectively. Mean aneurysm size was 9.2 ± 0.4 mm. Fifty-nine percent of patients demonstrated 100% coil obliteration and 81% had 90% or higher occlusion at last follow-up angiography. A total of 19 patients (8.3%) underwent retreatment of their aneurysms during the follow-up period. Angiographic in-stent stenosis was seen in 3.4% and thromboembolic events occurred in 4.4%. Overall, 90% of patients who underwent Enterprise-assisted coiling had a modified Rankin Scale score of 2 or less at last follow-up. A poor modified Rankin Scale score was strongly associated with rupture status (P < .001). CONCLUSION: Although this study is limited by its retrospective nature, the Enterprise stent system appears to be an effective, safe, and durable treatment for intracranial aneurysms when used in conjunction with coiling.

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Surgical Telementoring and Surginars with Added Virtual Layer using 5G Network

International Journal for Research in Applied Science and Engineering Technology ◽

10.22214/ijraset.2021.36403 ◽

2021 ◽

Vol 9 (VI) ◽

pp. 624-629

Author(s):

Ankit Verma

Keyword(s):

Health Care ◽

Human Resource ◽

High Speed ◽

Data Transfer ◽

Medical Science ◽

High Volume ◽

Well Being ◽

Healthcare Sector ◽

Surgical Expertise ◽

5G Network

Healthcare sector has always been a key sector for social and economic well-being of any nation and since COVID-19 pandemic it has gained a center stage. Human resources are at the core of health care system. However, there is an acute shortage of doctors, nurses, and other health care workers. Brunt of scarce human resource is starker at specialization level. 5G network may provide a solution to this problem by human resource capacity building in some of the most complex areas of medical science. It may also provide an access to surgical expertise distributed globally. The low latency, high volume and high-speed data transfer allows sharing live surgical feed which may enhance the learning and assistance process. Hence, a synergy is achieved of physical and virtual world and a potential business model can be developed in such ecosystem. This work explores the requirements, architecture, implementation strategy, roles, and responsibilities of various stakeholders etc. to provide surgical expertise on a 5G network.

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