#239 Trident Arterial Reconstruction in Rob. Assist. Kidney Transplantation-Dr. Priyadarshi Ranjan

This is one of the 2023 KS International Innovation Awards videos selected for inclusion in the Vattikuti Foundation – ORSI Humans at the Cutting Edge of Robotic Surgery Conference, October 6, 7 & 8, 2023 in Ghent, Belgium. Posting does not imply that is has been selected as a Finalist, just that the content will be discussed at the Conference.

From the entry: Title: Trident Arterial Reconstruction in Robotic Assisted Kidney Transplantation

Aim: To present an innovative surgical technique of reconstruction of three renal arteries in the graft kidney during robotic kidney transplantation.

Methods: During left laparoscopy donor nephrectomy, all three renal arteries were sequentially clipped and the left kidney was harvested. The kidney was cooled and all three arteries were perfused and flushed till the effluent was clear. All arteries were dissected till the hilum and the graft was defatted using a harmonic scalpel for effective vessel sealing. A pantaloon was made in a standard fashion using prolene 7.0 sutures in the upper and the middle artery. The opposite wall of the middle artery was then incised and the second pantaloon was made between the middle and lower arteries. The kidney was introduced to the recipient via the gel point. First the renal vein was sutured using CV-6 suture. The common reconstruction trident stump was then sutured end to side fashion with external iliac artery as per the standard steps of robotic kidney transplantation using CV-7 Goretex suture.

Results: The kidney was perfused immediately after releasing the clamps and diuresis was prompt. There was no significant bleeding. There was no graft delayed function.

Conclusion: Trident reconstruction of three donor renal arteries is a safe and effective way of vascular reconstruction and kidney transplantation using a robot.

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