A case report of a difficult dissection of the iliac vessels conducted by means of the harmonic scalpel during a kidney transplantation

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Abstract

Background. The “difficult” preparation of iliac vessels in thekidney transplant recipient caused by a perivascular fibrosis withsatellite lymphadenopathy is sometimes burdened by post-transplantcomplications (lymphocele, seroma and hematoma). Both iliac vascularadhesions and satellite lymphoadenopaty are often due to reiteratefemoral cannulation aimed to hemodialysis.Patients and Methods: The case report concerns a 60 years oldfemale uremic patient, on dialysis for about 4 years with perivascularfibrosis and pelvic lymphadenopathy caused by bilateral femoralartery catheterization. In the course of kidney transplant, preparationof the iliac vessels was performed by ultrasonic scalpel. In the casewe handled there was no incidence of immediate, medium and longterm post operative complications, with a considerable reduction of theoperative time in the vascular dissection performed without ligation.Often the long dialytic period, the same nephropathy, reiterative femoralcatheterization determine perivascular fibrosis and/or consensuallymphadenopathy. In these cases, in light of initial experience, theuse of ultrasonic scalpel enables easy dissection by the coagulativesynthesis not only of vascular compartment but also of the lymphaticduct whose leakage, particularly in these cases, creates a favourablecondition to hematoma and / or lymphocele formation. These complications,although rarely jeopardize patient’s life, however, may affectthe outcome of transplantation in terms of morbidity and survival ofthe organ. The use of ultrasonic scalpel ensures total control of vascularand lymphatic compartment coagulation, alongside a reduction in thetime of surgical dissection.
Original languageEnglish
Pages (from-to)227-229
Number of pages3
JournalLA CLINICA TERAPEUTICA
Volume162
Publication statusPublished - 2011

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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