A Human Cadaver Model For Laparoscopic Kidney Transplant

Abstract

Objectives: To evaluate the technique of laparoscopic kidney transplant and demonstrate the feasibility of this procedure by an extraperitoneal approach. Materials and Methods:The procedure was performed on 2 human cadavers. Retroperitoneal endoscopic left nephrectomy was performed. An extraperitoneal space was established by inflation of a balloon dilator. The external iliac artery and vein were exposed. A Pfannenstiel incision (6 cm) was made and a hand-access device was used. The renal artery was anastomosed to the external iliac artery (end-to-side anastomosis); the renal vein was anastomosed to the external iliac vein (end-to-side anastomosis). The ureter was anastomosed to the bladder with an extravesical tunnelling technique. Results: The donor kidney grafts were obtained successfully. The preparation of the external iliac artery and vein was satisfactory. The entire procedure for the renal artery, renal vein, and ureteral anastomoses was performed with laparoscopic technique without any difficulty.Conclusions: The present model on human cadavers may provide a feasible approach for training surgeons to perform human laparoscopic kidney transplant. The present technique may be applied to clinical human kidney transplant.

The novel laparoscopic training 3D model in urology with surgical anatomic remarks: Fresh-frozen cadaveric tissue

“…[4] The three dimensional environment of laparoscopic teaching effectively contributes to the teaching of abdominopelvic anatomy. [15] Also, cadaveric models have been used to assess the feasibility of new procedures such as perineal robot-assisted laparoscopic prostatectomy [16] and laparoscopic kidney transplantation [17] or evaluation of newer surgical instruments. [18] Laparoscopic cadaveric radical nephrectomy model Laparoscopic radical nephrectomy is recommended for patients with T2 tumours and localized renal masses not treatable by nephron-sparing surgery.…”

Laparoscopic Kidney Transplant by Extra Peritoneal Approach: The Safe Transition From Laboratory to the Clinic

“…We predict that the vessel anastomotic time will be reduced significantly with the improvement of the skills over the future cases. The whole procedure of this case took longer than we did in the establishment of deceased donor model (11). This has been attributed to many factors on the day of surgery.…”

“…It was demonstrated that laparoscopic kidney transplant was feasible and safe and that immediate renal function can be achieved (8)(9)(10). Following the experiment, a human cavader model was established for laparoscopic kidney transplant by using extra-peritoneal approach (11). In addition, the lead surgeon visited the transplant unit, where Dr. Modi had performed over 72 cases of laparoscopic kidney transplant by transperitoneal approach (12).…”

Simultaneous living donor orthotopic renal transplantation and bilateral nephrectomy for recurrent renal cell carcinoma and renal failure: case report and review of literature

“… 13 Thus, experimental animal and human cadaver models dealing with the idea of laparoscopist ORT are the next stages in the exploration of this technique’s new possibilities. 16 – 18 Experimental models on animals are used today to perfect the ORT in the pursuit of reducing the warm ischemia time. 19 Despite the high promise of these new techniques and improvements, extensive research is needed to embed this techniques and improvements into the medical practice.…”