Following surgical disinfection, and sterile draping, perform a median laparotomy to open the abdomen, and use a standard abdominal retractor to expose the surgical field. Open the peritoneal layer, and use a monopolar cautery, bipolar forceps, and fine scissors to dissect the left kidney and ureter from any adherent tissue. Then, use a 3-0 polyglactin suture to ligate and divide the left ureter at least 10 centimeters distal to the kidney hilum.
To retrieve the graft kidney, use vascular clamps to close the renal artery and vein, close to the aorta and vena cava, and cut the vessels above the clamps. Then, give the kidney to the back table team for additional preparation, and use a 5-0 polypropylene suture to close the stump of the renal artery and the renal vein.
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