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Deviceless low-pressure operation; a cost-effective way to reduce CO2-induced barotrauma during hand-assisted laparoscopic donor nephrectomy.

Abstract
Between March 2008 and March 2011, hand-assisted laparoscopic donor nephrectomles were performed on 70 patients. Following the first 26 cases undertaken based on guidelines in the literature, we modified the procedure to avoid barotrauma to the kidney caused by the usual 12-13 mm Hg CO(2) pneumoperitoneum or pneumoretroperitoneum. The perirenal CO(2) pressure, therefore, was decreased to 8 mm Hg from the beginning of the surgery; the operation was performed without using a handport. Our early experience with the modified technique suggested that the safety and duration of the procedure were not affected but the incidence of delayed graft function due to barotrauma was decreased, a cost-effective improvement.
AuthorsJ B Kovacs, G Branstetter, L Piros, P A Deak
JournalTransplantation proceedings (Transplant Proc) Vol. 44 Issue 7 Pg. 2136-8 (Sep 2012) ISSN: 1873-2623 [Electronic] United States
PMID22974935 (Publication Type: Journal Article)
CopyrightCopyright © 2012 Elsevier Inc. All rights reserved.
Chemical References
  • Carbon Dioxide
Topics
  • Adult
  • Aged
  • Barotrauma (chemically induced, prevention & control)
  • Carbon Dioxide (adverse effects)
  • Cost-Benefit Analysis
  • Female
  • Hand
  • Humans
  • Laparoscopy (methods)
  • Male
  • Middle Aged
  • Nephrectomy (methods)
  • Pressure
  • Tissue Donors

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