No abstract

Although huge improvement has been observed in endovascular repair of aneurysms involving visceral arteries, in urgent cases

IntroductionThe advantages of a minimally invasive nephrectomy are a faster recovery and better quality of life for the donors. Until recently, the majority of donor nephrectomies in Poland were done by open surgery.AimTo present a single centre experience in hand-assisted laparoscopic donor nephrectomy (HALDN).Material and methodsThe first videoscopic left donor nephrectomy in Poland was performed in our department in 2003 using a hand-assisted retroperitoneal approach. From 2011, we changed the method to a transperitoneal approach and started to harvest also right kidneys. Since then, it has become the method of choice for donor nephrectomy and has been performed in 59 cases. Preoperatively, kidneys were assessed by scintigraphy and by angio-computed tomography. We harvested 32 left and 27 right kidneys. There were double renal arteries in 2 cases and triple renal arteries in 1 case. The warm ischaemia time (WIT) was 80–420 s (average 176.13 s); operative time was 85–210 min (average 140 min).ResultsAll procedures were uncomplicated, and all donors were discharged after 2–8 days with normal creatinine levels. The average follow-up period lasted 23 months (1–51 months). Out of all of the cases, 1 case had two minor complications, while all others were uneventful. None of the donors were lost to follow-up. All of the kidneys were transplanted. There were 2 cases of delayed graft function (DGF) and 2 cases of ureter necrosis. One of those kidneys was lost in the third postoperative week.ConclusionsOur limited experience shows that HALDN is a safe method and should be used routinely instead of open surgery.

Paper show possibilities to optimization of exploitation process of single edge tools. It decrease cost of machining using optimizing the use of the cutting edge. This possibility was presented for single edge tools in oblique and orthogonal cutting. In oblique cutting was presented optimizing the use of the cutting edge by partially exchange of active section of the cutting edge. It is shown for straight edges. Presents model of special tool and result of made experiments, which shows possibilities to increase tool life. Second presented possibilities is orthogonal cutting with round insert. Presented results of calculations of number cutting edges from one round insert by optimizing the use of the cutting edge. For orthogonal cutting was used normal market construction tools for round inserts. Presents first results of surface roughness for tools with worn up cutting edge and rotate for exchange this worn up fragment of cutting edge. In this case number of edges cutting insert increase many times. This can many times reduce the cost of tools in cutting especially in turning.

No abstract