우리는 우리가 비디오를 제작하고 게시할 수있게이 일을 통해 무제한 교육 교부금을 지원하기위한 응용 의료를 인정하고 싶습니다.

<dt&gt; 단일 포트 기증자의 신 :</dt&gt;<ol&gt;<li왼쪽 위로와 함께 오른쪽 측면 decubitus 위치에&gt; 플레이스 환자</li&gt;<li&gt; 작동 외과는 외과의의 오른쪽 caudad에 서있 보조 카메라 드라이버와 복부를 마주 서서 것입니다</li&gt;<li스트레칭에 배꼽 이상&gt; 측정 5cm 절개</li&gt;<li&gt; 배꼽에 절개를 만들고 복강를 입력합니다.</li&gt;<li&gt; 알렉시스 상처 견인기을 플레이스</li&gt;<li젤 포인트 인감 (2 5mm 포트 1 포트 15mm)에&gt; 플레이스 적절한 복강경 포트로 disrected 및 동영상에 표시</li&gt;<li&gt; 플레이스 젤 포인트 알렉시스 견인기에 밀봉하고 복부를 Insuffolate</li&gt;<li&gt; Retroperitoneum의 해제 내림차순 콜론 시켜라</li&gt;<li&gt;에서 비장을 시켜라 비장과 신장의 위쪽 기둥 사이에 비행기를 만드는 중간에 가로</li&gt;<li&gt; 신장의 낮은 극까지 장골의 혈관의 수준에서 Ureter와 Gonadal 베인을 해부하다</li&gt;<li&gt; Hilum의 영역에서 신장 베인에 Gonadal 베인을 따르십시오. 필요한 경우 Gonadal 정맥은 신장 베인 근처 출혈도 잡았하고 나눌 수 있습니다</li&gt;<li&gt; 어떤 룸버 혈관을 확인하고 분할</li&gt;<li&gt; 확인하고 클립 사이에 부신 정맥을 나누기</li&gt;<li&gt; Circumferentially 신장 정맥을 절개하다</li&gt;<li&gt; 신장 동맥을 확인하고 circumferentially 그것을 해부하다</li&gt;<li&gt; retroperitoneum의 전체 신장을 Mobilze</li&gt;<li&gt; 페이스 하단 5mm 포트가 젤 포인트 인감에 배치했다 5~12밀리미터 포트</li&gt;<li&gt; 장골의 Vesselswith 엔도 - GIA 스테플러에서 Ureter와 Gonadal 정맥 Ligate 및 분할</li&gt;<li&gt; endoshears로 나누어 다음 엔도 - TA 혈관 스테이플러로 신장 동맥을 Ligate하고</li&gt;<li&gt; Ligate 및 엔도 - GIA 스테이플러로 신장 정맥을 나누어</li&gt;<li&gt;의 신장 및 대형 Endocatch 가방 플레이스</li&gt;<li&gt; 젤 포인트 인감과 알렉시스 견인기 제거</li&gt;<li&gt; 복강에서 신장을 제거</li&gt;<li&gt; 젤 포인트 인감 교체</li&gt;<li&gt; hemostasis에 대한 조사 및 비장과 함께 적절한 위치에 하강 콜론 교체</li&gt;<li&gt; 피부 절개 후 복벽의 근막을 닫고</li&gt;<li&gt; 플레이스 드레싱</li&gt;</ol

<ol>
	<li>Canes, D., Berger, A., Aron, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Laparo-endoscopic+single+site+(LESS)+versus+standard+laparoscopic+left+donor+nephrectomy:+matched-pair+comparison.">Laparo-endoscopic single site (LESS) versus standard laparoscopic left donor nephrectomy: matched-pair comparison.</a> Eur Urol. 57, 95-101 (2010).</li><li>Skrekas, G., Papalois, V. E., Mitsis, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Laparoscopic+live+donor+nephrectomy:+a+step+forward+in+kidney+transplantation.">Laparoscopic live donor nephrectomy: a step forward in kidney transplantation.</a> JSLS. 7, 197-206 (2003).</li><li>Giessing, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Laparoscopic+living-donor+nephrectomy.">Laparoscopic living-donor nephrectomy.</a> Nephrol Dial Transplant. 19, iv36-iv40 (2004).</li><li>Eng, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+role+of+laparoscopic+donor+nephrectomy+in+renal+transplantation.">The role of laparoscopic donor nephrectomy in renal transplantation.</a> Am Surg. 76, 349-353 (2010).</li><li>Kommu, S. S., Kaouk, J. H., Rane, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Laparo-endoscopic+single-site+surgery:+preliminary+advances+in+renal+surgery.">Laparo-endoscopic single-site surgery: preliminary advances in renal surgery.</a> BJU Int. 103, 1034-1037 (2009).</li><li>Canes, D., Desai, M. M., Aron, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Transumbilical+single-port+surgery:+evolution+and+current+status.">Transumbilical single-port surgery: evolution and current status.</a> Eur Urol. 54, 1020-1029 (2008).</li><li>Desai, M. M., Berger, A. K., Brandina, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Laparoendoscopic+single-site+surgery:+initial+hundred+patients.">Laparoendoscopic single-site surgery: initial hundred patients.</a> Urology. 74, 805-812 (2009).</li><li>Ganpule, A. P., Dhawan, D. R., Kurien, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Laparoendoscopic+single-site+donor+nephrectomy:+a+single-center+experience.">Laparoendoscopic single-site donor nephrectomy: a single-center experience.</a> Urology. 74, 1238-1240 (2009).</li><li>Gill, I. S., Canes, D., Aron, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Single+port+transumbilical+(E-NOTES)+donor+nephrectomy.">Single port transumbilical (E-NOTES) donor nephrectomy.</a> J Urol. 180, 637-641 (2008).</li><li>Raman, J. D., Bensalah, K., Bagrodia, A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Laboratory+and+clinical+development+of+single+keyhole+umbilical+nephrectomy.">Laboratory and clinical development of single keyhole umbilical nephrectomy.</a> Urology. 70, 1039-1042 (2007).</li><li>Raybourn, J. H., Rane, A., Sundaram, C. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Laparoendoscopic+single-site+surgery+for+nephrectomy+as+a+feasible+alternative+to+traditional+laparoscopy.">Laparoendoscopic single-site surgery for nephrectomy as a feasible alternative to traditional laparoscopy.</a> Urology. 75, 100-103 (2010).</li><li>Dindo, D., Demartines, N., Clavien, P. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Classification+of+surgical+complications:+a+new+proposal+with+evaluation+in+a+cohort+of+6336+patients+and+results+of+a+survey.+Ann+Surg.">Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg.</a> 240, 205-213 (2004).</li><li>Bargman, V., Sundaram, C. P., Bernie, J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Randomized+trial+of+laparoscopic+donor+nephrectomy+with+and+without+hand+assistance.">Randomized trial of laparoscopic donor nephrectomy with and without hand assistance.</a> J Endourol. 20, 717-722 (2006).</li><li>El-Galley, R., Hood, N., Young, C. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Donor+nephrectomy:+A+comparison+of+techniques+and+results+of+open,+hand+assisted+and+full+laparoscopic+nephrectomy.">Donor nephrectomy: A comparison of techniques and results of open, hand assisted and full laparoscopic nephrectomy.</a> J Urol. 171, 40-43 (2004).</li><li>Velidedeoglu, E., Williams, N., Brayman, K. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+open,+laparoscopic,+and+hand-assisted+approaches+to+live-donor+nephrectomy.">Comparison of open, laparoscopic, and hand-assisted approaches to live-donor nephrectomy.</a> Transplantation. 74, 169-172 (2002).</li><li>Raman, J. D., Bagrodia, A., Cadeddu, J. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Single-incision,+umbilical+laparoscopic+versus+conventional+laparoscopic+nephrectomy:+a+comparison+of+perioperative+outcomes+and+short-term+measures+of+convalescence.">Single-incision, umbilical laparoscopic versus conventional laparoscopic nephrectomy: a comparison of perioperative outcomes and short-term measures of convalescence.</a> Eur Urol. 55, 1198-1204 (2009).</li></ol>

박사 데이비드 Leeser 및 박사 요셉 델 Pizzo가 적용 의료 후원 과정에서 단일 포트 기술을 가르쳐 모두.

단일 포트 기증자 신은 기증자 신의 진화에 가능한 다음 단계입니다. 시간에 프로 시저에서 단계에서 설명한 동영상과 같은 측면 철회와 이동성에 측면을 제한 단일 포트 고유의 문제로 인해 고장 달성해야합니다. cosmesis 우수하고 환자는 매우 빨리 활동으로 돌아갑니다. 프로 시저가 발전 새로운 악기 개발된다는 단일 포트 항목을 통해 점점 더 많은 복잡한 작업의 이상의 달성에 보좌관됩니다.

single port donor nephrectomy

2007 년 Rane는 Endourology의 세계 대회에서 작은 비 작동 신장을위한 최초의 단일 포트 신을 소개하고 있습니다. 그때 이후로, 신에 대한 단일 포트 수술의 사용은 기증자의 신을 포함하도록 확장되었습니다. 향후 2 년 동안 기술은 기증자의 신을 포함 nephrectomies의 많은 다른 유형에 채택되었습니다. 우리는 Gelpoint 장치를 사용하여 단일 포트 기증자 신위한 기법을 제시한다. 우리는 성공적으로 100 개 이상의 환자에서이 수술을 수행하고 1000 복강경 nephrectomies 우리의 경험이 경험을 추가할 수 있습니다. 적절한 장비와 기술로, 단일 포트 기증자 신는 라이브 기증자의 대다수에 안전하고 효과적으로 수행할 수 있습니다. 우리는 수술 시간과 가장 중요한 우리의 이식 결과는 단일 포트 기증자 신의 채택과 함께 크게 변화하지 않은 것으로 나타났습니다. 우리는 단일 포트 기증자 신 사는 기증자의 치료에서 한 단계 발전을 나타냅니다 있다고 생각합니다.

Watch this Scientific Journal Video about Single Port Donor Nephrectomy at JoVE.com

Single Port Donor Nephrectomy

복강경 기술이 20 년 전에 도입된 이래 단일 포트 복강경 수술 아무것도 같은 외과 치료 치료의 기준을 변화하고 있습니다. 우리는 Gelpoint 장치를 사용하여 단일 포트 기증자 신의 기법을 제시한다. 우리는 성공적으로 100 환자에서이 수술을 수행했습니다.

단일 포트 공여 신

In 2007, Rane presented the first single port nephrectomy for a small non-functioning kidney at the World Congress of Endourology.  Since that time, the ...

Research

JoVE Journal

Medicine

48.6K 조회수.  Weill Cornell Medical College of Cornell University. 복강경 기술이 20 년 전에 도입된 이래 단일 포트 복강경 수술 아무것도 같은 외과 치료 치료의 기준을 변화하고 있습니다. 우리는 Gelpoint 장치를 사용하여 단일 포트 기증자 신의 기법을 제시한다. 우리는 성공적으로 100 환자에서이 수술을 수행했습니다.

비디오: Single Port Donor Nephrectomy

Corneal Donor Tissue Preparation for Endothelial Keratoplasty

Over the past ten years, corneal transplantation surgical techniques have undergone revolutionary changes1,2. Since its inception, traditional full thickness corneal transplantation has been the treatment to restore sight in those limited by corneal disease. Some disadvantages to this approach include a high degree of post-operative astigmatism, lack of predictable refractive outcome, and disturbance to the ocular surface. The development of Descemet's stripping endothelial keratoplasty (DSEK), transplanting only the posterior corneal stroma, Descemet's membrane, and endothelium, has dramatically changed treatment of corneal endothelial disease. DSEK is performed through a smaller incision; this technique avoids 'open sky' surgery with its risk of hemorrhage or expulsion, decreases the incidence of postoperative wound dehiscence, reduces unpredictable refractive outcomes, and may decrease the rate of transplant rejection3-6.
Initially, cornea donor posterior lamellar dissection for DSEK was performed manually1 resulting in variable graft thickness and damage to the delicate corneal endothelial tissue during tissue processing. Automated lamellar dissection (Descemet's stripping automated endothelial keratoplasty, DSAEK) was developed to address these issues. Automated dissection utilizes the same technology as LASIK corneal flap creation with a mechanical microkeratome blade that helps to create uniform and thin tissue grafts for DSAEK surgery with minimal corneal endothelial cell loss in tissue processing.
Eye banks have been providing full thickness corneas for surgical transplantation for many years. In 2006, eye banks began to develop methodologies for supplying precut corneal tissue for endothelial keratoplasty. With the input of corneal surgeons, eye banks have developed thorough protocols to safely and effectively prepare posterior lamellar tissue for DSAEK surgery. This can be performed preoperatively at the eye bank. Research shows no significant difference in terms of the quality of the tissue7 or patient outcomes8,9 using eye bank precut tissue versus surgeon-prepared tissue for DSAEK surgery. For most corneal surgeons, the availability of precut DSAEK corneal tissue saves time and money10, and reduces the stress of performing the donor corneal dissection in the operating room. In part because of the ability of the eye banks to provide high quality posterior lamellar corneal in a timely manner, DSAEK has become the standard of care for surgical management of corneal endothelial disease.
The procedure that we are describing is the preparation of the posterior lamellar cornea at the eye bank for transplantation in DSAEK surgery (Figure 1).

Endothelial corneal transplantation is a surgical technique for treatment of posterior corneal diseases. Mechanical microkeratome dissection to prepare tissue results in thinner, more symmetric grafts with less endothelial cell loss and improved outcomes. Dissections can be performed at the eye bank prior to corneal transplantation surgery.

내피 Keratoplasty을위한 각막 기증자 조직 준비

Over the past ten years, corneal transplantation surgical techniques have undergone revolutionary changes1,2. Since its inception, traditional full ...

연구

의학

Modeling Spontaneous Metastatic Renal Cell Carcinoma (mRCC) in Mice Following Nephrectomy

One of the key challenges to improved testing of new experimental therapeutics in renal cell carcinoma (RCC) is the development of models that faithfully recapitulate early- and late-stage metastatic disease progression. Typical tumor implantation models utilize ectopic or orthotopic primary tumor implantation, but few include systemic spontaneous metastatic disease that mimics the clinical setting. This protocol describes the key steps to develop RCC disease progression stages similar to patients. First, it uses a highly metastatic mouse tumor cell line in a syngeneic model to show orthotopic tumor cell implantation. Methods include superficial and internal implantation into the sub-capsular space with cells combined with matrigel to prevent leakage and early spread. Next it describes the procedures for excision of tumor-bearing kidney (nephrectomy), with critical pre- and post- surgical mouse care. Finally, it outlines the steps necessary to monitor and assess micro-and macro-metastatic disease progression, including bioluminescent imaging as well provides a detailed visual necropsy guide to score systemic disease distribution. The goal of this protocol description is to facilitate the widespread use of clinically relevant metastatic RCC models to improve the predictive value of future therapeutic testing.&#160;

Modeling Spontaneous Metastatic Renal Cell Carcinoma mRCC in Mice Following Nephrectomy

Models of spontaneous metastatic renal cell carcinoma (RCC) disease progression can be used for evaluating treatments in a clinically relevant setting. This protocol demonstrates different procedures for orthotopic kidney tumor cell implantation, proper nephrectomy, and finally outlines a necropsy guide for visual and bioluminescent scoring of metastatic burden and localization.

마우스의 자발적인 전이성 신장 세포 암 (mRCC)를 모델링에 따라 신장 절제술

One of the key challenges to improved testing of new experimental therapeutics in renal cell carcinoma (RCC) is the development of models that faithfully ...

Corneal Donor Tissue Preparation for Descemet's Membrane Endothelial Keratoplasty

Descemet&#8217;s Membrane Endothelial Keratoplasty (DMEK) is a form of corneal transplantation in which only a single cell layer, the corneal endothelium, along with its basement membrane (Descemet&#39;s membrane) is introduced onto the recipient&#39;s posterior stroma3. Unlike Descemet&#8217;s Stripping Automated Endothelial Keratoplasty (DSAEK), where additional donor stroma is introduced, no unnatural stroma-to-stroma interface is created. As a result, the natural anatomy of the cornea is preserved as much as possible allowing for improved recovery time and visual acuity4. Endothelial Keratoplasty (EK) is the procedure of choice for treatment of endothelial dysfunction. The advantages of EK include rapid recovery of vision, preservation of ocular integrity and minimal refractive change due to use of a small, peripheral incision1. DSAEK utilizes donor tissue prepared with partial thickness stroma and endothelium. The rapid success and utilization of this procedure can be attributed to availability of eye-bank prepared precut tissue. The benefits of eye-bank preparation of donor tissue include elimination of need for specialized equipment in the operating room and availability of back up donor tissue in case of tissue perforation during preparation. In addition, high volume preparation of donor tissue by eye-bank technicians may provide improved quality of donor tissue. DSAEK may have limited best corrected visual acuity due to creation of a stromal interface between the donor and recipient cornea. Elimination of this interface with transplantation of only donor Descemet&#39;s membrane and endothelium in DMEK may improve visual outcomes and reduce complications after EK5. Similar to DSAEK, long term success and acceptance of DMEK is dependent on ease of availability of precut, eye-bank prepared donor tissue. Here we present a stepwise approach to donor tissue preparation which may reduce some barriers eye-banks face in providing DMEK grafts.

Corneal Donor Tissue Preparation for Descemet&#039;s Membrane Endothelial Keratoplasty

Endothelial keratoplasty is a surgical technique continuously evolving as advancements result in transplantation of thinner grafts with each succession1. Here we present a technique for controlled manual tissue dissection to allow safe and repeatable separation of endothelium and Descemet&#39;s membranes from donor corneoscleral buttons for transplantation2.

데스 메막 내피 각막 이식을위한 각막 기증자의 조직 준비

Descemet&#8217;s Membrane Endothelial Keratoplasty (DMEK) is a form of corneal transplantation in which only a single cell layer, the corneal endothelium, ...

Ex Situ Normothermic Machine Perfusion of Donor Livers

In contrast to conventional static cold preservation (0-4 &#176;C), ex situ machine perfusion may provide better preservation of donor livers. Continuous perfusion of organs provides the opportunity to improve organ quality and allows ex situ viability assessment of donor livers prior to transplantation. This video article provides a step by step protocol for ex situ normothermic machine perfusion (37 &#176;C) of human donor livers using a device that provides a pressure and temperature controlled pulsatile perfusion of the hepatic artery and continuous perfusion of the portal vein. The perfusion fluid is oxygenated by two hollow fiber membrane oxygenators and the temperature can be regulated between 10 &#176;C and 37 &#176;C. During perfusion, the metabolic activity of the liver as well as the degree of injury can be assessed by biochemical analysis of samples taken from the perfusion fluid. Machine perfusion is a very promising tool to increase the number of livers that are suitable for transplantation.

Ex Situ Normothermic Machine Perfusion of Donor Livers

Here we present a protocol describing oxygenated ex situ machine perfusion of donor liver grafts. This article contains a step by step protocol to procure and prepare the liver graft for machine perfusion, prepare the perfusion fluid, prime the perfusion machine and perform oxygenated normothermic machine perfusion of the liver graft.

기증자의 간을의 현지 외 정상 체온 기계 관류

In contrast to conventional static cold preservation (0-4 &#176;C), ex situ machine perfusion may provide better preservation of donor livers. Continuous ...

Low-Cost Single-Port (LoCoSP) Device for a Transcervical Approach in Minimally Invasive Transhiatal Esophagectomy

Esophagectomy remains the preferred option to achieve curative treatment in advanced esophageal cancer, but the choice of surgical approach remains controversial. A transthoracic approach may improve lymph node dissection, but it has considerable morbidity and respiratory complications. Transhiatal access has been demonstrated as an efficient means of minimizing post-operative complications. Minimally invasive transhiatal esophagectomy may reduce operative trauma and morbidity as well as enhance postoperative recovery with no compromise in cancer recurrence or survival. Nevertheless, it has a technical limitation in terms of cervical esophagus dissection. Thus, a low-cost single-port device was developed to complete upper mediastinal dissection by a transcervical approach during minimally invasive transhiatal esophagectomy. This device uses a nasogastric tube, a number-eight sterile glove, a sterile sponge, and 3 permanent 5-mm trocars. The step-by-step process of transhiatal esophagectomy and the development of this device are described. This technique allows for the dissection of the upper mediastinum, as well as the esophagus over the aortic arch and behind the superior portion of the trachea. The harvesting of lymph nodes along the left recurrent laryngeal nerve and paratracheals was improved.

Low-Cost Single-Port LoCoSP Device for a Transcervical Approach in Minimally Invasive Transhiatal Esophagectomy

Here, we describe a step-by-step description of transhiatal esophagectomy and the development of a low-cost single-port device for a transcervical approach in a minimally invasive transhiatal esophagectomy.

최소 침습성 경막식 식도 절제술에서 경피 성 접근을위한 저비용 단일 포트 (LoCoSP) 장치

Esophagectomy remains the preferred option to achieve curative treatment in advanced esophageal cancer, but the choice of surgical approach remains ...

Lung Rapid Recovery Procurement Combined with Abdominal Normothermic Regional Perfusion in Controlled Donation after Circulatory Death

Controlled donation after circulatory death (cDCD) has contributed to increasing donor numbers all over the world. Experiences published in the last years confirm that the outcomes after lung transplantation from cDCD are similar to those from brain death donors; however, the utilization of lungs from asystole donors remains low. Several reasons may be involved: different legal frameworks among countries and centers with different premortem interventions, inadequate lung donor care before procurement, or even poor experience with cDCD procedures and protocols.
Initially, the rapid recovery technique was commonly employed for the procurement of thoracic and abdominal organs in cDCD, but, in the last decade, abdominal normothermic regional perfusion (ANRP) with extracorporeal membrane oxygenation devices has become a useful method to restore blood flow to abdominal organs, allowing their quality improvement and their functional assessment prior to transplantation. This makes the donation procedure more complex and generates doubts about injury to the grafts due to dual temperature.
The aim of this article is to describe a protocol based on a single center experience with Maastricht III donors combining lung cooling rapid recovery in the thorax and abdominal normothermic regional perfusion. Tips and tricks focused on premortem interventions and lung procurement procedure techniques are explained. This may help to minimize the reluctance among professionals to use this combined technique and encourage other donor centers to use it, despite the increased complexity of the procedure.

The protocol combines a lung cooling rapid recovery technique with abdominal normothermic regional perfusion for abdominal graft procurement in controlled asystole donors, which is a safe and useful method to expand the donor pool.

순환기 사망 후 통제된 기증에서 복부 정상 국소 관류와 결합된 폐 빠른 회복 조달

Controlled donation after circulatory death (cDCD) has contributed to increasing donor numbers all over the world. Experiences published in the last years ...

Porcine Liver Transplantation Without Veno-Venous Bypass As an Extended Criteria Donor Model

Liver transplantation is regarded as the gold standard for the treatment of a variety of fatal hepatic diseases. However, unsolved issues of chronic graft failure, ongoing organ donor shortages, and the increased use of marginal grafts call for the improvement of current concepts, such as the implementation of organ machine perfusion. In order to evaluate new methods of graft reconditioning and modulation, translational models are required. With respect to anatomical and physiological similarities to humans and recent progress in the field of xenotransplantation, pigs have become the main large animal species used in transplantation models. After the initial introduction of a porcine orthotopic liver transplant model by Garnier et al. in 1965, several modifications have been published over the past 60 years.
Due to specifies-specific anatomical traits, a veno-venous bypass during the anhepatic phase is regarded as a necessity to reduce intestinal congestion and ischemia resulting in hemodynamic instability and perioperative mortality. However, the implementation of a bypass increases the technical and logistical complexity of the procedure. Furthermore, associated complications such as air embolism, hemorrhage, and the need for a simultaneous splenectomy have been reported previously.
In this protocol, we describe a model of porcine orthotopic liver transplantation without the use of a veno-venous bypass. The engraftment of donor livers after static cold storage of 20 h - simulating extended criteria donor conditions - demonstrates that this simplified approach can be performed without significant hemodynamic alterations or intraoperative mortality and with regular uptake of liver function (as defined by bile production and liver-specific CYP1A2 metabolism). The success of this approach is ensured by an optimized surgical technique and a sophisticated anesthesiologic volume and vasopressor management.
This model should be of special interest for workgroups focusing on the immediate postoperative course, ischemia-reperfusion injury, associated immunological mechanisms, and the reconditioning of extended criteria donor organs.

In this protocol, a model of porcine orthotopic liver transplantation after static cold storage of donor organs for 20 h without the use of a veno-venous bypass during engraftment is described. The approach uses a simplified surgical technique with minimization of the anhepatic phase and sophisticated volume and vasopressor management.

확장 기준 기증자 모델로서의 정맥 우회술이 없는 돼지 간 이식

Liver transplantation is regarded as the gold standard for the treatment of a variety of fatal hepatic diseases. However, unsolved issues of chronic graft ...

Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction

Reduced-port laparoscopic surgery (RPLS) has been widely used for the radical resection of gastrointestinal tumors. Single-surgeon, three-port, laparoscopic radical resection for sigmoid colon or high rectal cancer with natural orifice specimen extraction surgery (NOSES) has the advantage of a small incision, quick postoperative recovery, and short hospital stay. Yet, there are still only a few reports on NOSES. This paper describes the indications, preoperative preparations, surgical steps, and precautions for single-surgeon, three-port, laparoscopic radical resection of the sigmoid colon and high rectal cancer, and intraoperative specimen collection through the natural orifice. 
The protocol focuses on the steps of radical dissection and the main technical points of resection and reconstruction. At the same time, a procedure for fixing an anvil seat by self-traction of extracorporeal silk thread, used for purse-string suture fixation after the proximal anvil was placed in the abdominal cavity, was creatively improved. This operation could effectively avoid problems such as an insufficient proximal intestinal tube, shaking off the anvil seat, and weak purse-string suture during a single operation. The surgical care had less variability and was easy to perform, effectively avoiding postoperative anastomotic leakage and bleeding due to excessive intraoperative anastomotic tissue. This surgery could be widely promoted in primary hospitals.

Here, we present a protocol to successfully perform single-surgeon, three-port, laparoscopic resection for colorectal cancer with natural orifice specimen extraction.

자연 오리피스 표본 추출을 통한 대장암에 대한 단일 외과의, 3포트, 복강경 절제술의 임상 적용

Reduced-port laparoscopic surgery (RPLS) has been widely used for the radical resection of gastrointestinal tumors. Single-surgeon, three-port, ...

<meta charset="utf8"></head><body>작동하는 쥐 심장 관류 모델을 사용한 기증자 심장 보존 최적화

Using an Isolated Working Rat Heart Model to Test Donor Heart Preservation Strategies

Optimization of donor heart preservation solutions has played a key role in reducing ischemia-reperfusion injury in donor hearts during organ retrieval, transportation, and transplantation. Previous work from our laboratory showed that the addition of glyceryl trinitrate and erythropoietin to donor heart preservation solutions could significantly improve cardiac functional recovery after prolonged cold storage and in donation after circulatory death hearts. This supplementation protocol has been implemented in clinical use in transplant units around Australia, Belgium, and the United Kingdom. Here, we outline a protocol for testing supplementation strategies using an ex vivo isolated working rat heart (IWRH) perfusion circuit. Using this methodology, supplementation strategies can be tested in the context of prolonged cold static storage, donation after brain death, and donation after circulatory death donor heart preservation. Cardiac functional recovery, measured by aortic flow, coronary flow, cardiac output, pulse pressure, and heart rate, can be used to determine whether a particular preservation strategy can minimize ischemia-reperfusion injury of the donor heart.

<meta charset="utf8"></head><body>저자 스포트라이트: 고립된 쥐 심장 관류 연구를 통한 기증자 심장 보존 강화

We describe an ex vivo isolated working rat heart protocol to test donor heart preservation strategies. This paper describes the protocol for use in static cold storage of rodent donor hearts; however, the protocol can also be used for donor hearts obtained after donation after circulatory death and brain death.

기증자 심장 보존 전략을 테스트하기 위해 격리된 작업 쥐 심장 모델 사용

Optimization of donor heart preservation solutions has played a key role in reducing ischemia-reperfusion injury in donor hearts during organ retrieval, ...