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Intraoperative vascular localization to facilitate endopyelotomy after renal transplantation
Author(s) -
Siddins Mark,
Kanchanabat Burapa,
Rao M. Mohan
Publication year - 2001
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1046/j.1440-1622.2001.02166.x
Subject(s) - medicine , radiology , transplantation , surgery , doppler ultrasound , adipose capsule of kidney , doppler sonography , renal artery , ultrasound , kidney
Background : Pelviureteric junction (PUJ) obstruction after renal transplantation is uncommon. Surgical correction can be technically challenging due to dense perinephric adhesions and variable hilar vascular anatomy. Endopyelotomy is well established in the treatment of PUJ obstruction in native kidneys. Methods : The present paper reports the first experience of antegrade visual cold‐knife endopyelotmy performed in a renal allograft. In orientating the incision at the PUJ, preoperative imaging was supplemented by intrarenal Doppler ultrasound, using a probe designed for transoesophageal cardiac monitoring. To the authors’ knowledge this approach has not previously been reported. Results : Renal vascular relationships were readily indentified by identifying arterial and venous waveforms. Conclusions : For this uncommon procedure the use of intrarenal Doppler ultrasound provides greater security in avoiding inadvertent vascular injury.