Surgery setup images for Kidney Transplant

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Mayo stand and back table instruments for Kidney Transplant surgery setup

Clamping & Occluding

  • Allis Forceps

    Allis Forceps

  • Bulldog Clamp

    Bulldog Clamp

  • Curved Hemostat

    Curved Hemostat

  • Debakey Bulldog Clamp

    Debakey Bulldog Clamp

  • Fogarty Clamp

    Fogarty Clamp

  • Hemostatic Clip Applier

    Hemostatic Clip Applier

  • Kelly Forceps

    Kelly Forceps

  • Mosquito Clamp – Curved

    Mosquito Clamp – Curved

  • Right Angle Clamp

    Right Angle Clamp

  • Tonsil Clamp

    Tonsil Clamp

Cutting & Dissecting

  • #3 Knife Handle

    #3 Knife Handle

  • #7 Knife Handle

    #7 Knife Handle

  • Metzenbaum Scissor

    Metzenbaum Scissor

  • Potts Smith Scissors

    Potts Smith Scissors

  • Straight Mayo Scissor

    Straight Mayo Scissor

Grasping & Holding

  • Adson Forceps

    Adson Forceps

  • Debakey Forcep

    Debakey Forcep

  • Forester Sponge Forceps

    Forester Sponge Forceps

Retracting & Exposing

  • Army-Navy Retractor

    Army-Navy Retractor

  • Bookwalter Retractor

    Bookwalter Retractor

  • Richardson Retractor

    Richardson Retractor

Suctioning

  • Yankauer Suction

    Yankauer Suction

Suturing & Stapling

  • Castroviejo Needle Holder

    Castroviejo Needle Holder

  • Mayo-Hegar Needle Holder

    Mayo-Hegar Needle Holder

  • Micro Vascular Needle Holder

    Micro Vascular Needle Holder

  • Ryder Needle Holder

    Ryder Needle Holder

What to expect during Kidney Transplant

A kidney transplant is a surgical procedure in which a healthy kidney is transplanted into a person with kidney failure. The healthy kidney is usually donated from a deceased or living donor. The transplanted kidney is placed in the lower abdomen and connected to the recipient’s blood vessels and bladder. The new kidney then takes over the job of filtering waste and excess fluids from the body. Kidney transplantation is considered a successful treatment for end-stage kidney disease, as it can significantly improve the quality of life and increase lifespan compared to dialysis. However, the procedure also involves risks and requires lifelong medication to prevent rejection of the transplanted kidney.

Step 1: Preparing the Donor Kidney
The donor kidney will be brought to the operating room and will be prepared for implantation into the recipient. This involves cleaning off any excess fat and dissecting the vessels clean. The vessels may be shortened to make the anastomosis easier. If the kidney came from a deceased patient, an aortic cuff may be used.

Step 2: Reconstructing the Veins
The veins need to be reconstructed, and there will be branches that will need to be ligated, but a large renal vein will be kept.

Step 3: Placing the Kidney
The kidney will either be placed in the iliac fossa or in the retroperitoneum.

Step 4: Making the Incision
A large incision with a 10 blade will be made, and the external oblique muscle and fascia are dissected. The internal oblique and transverse muscles will be divided to expose the peritoneum. The inferior epigastric will be ligated, and the spermatic cord will be preserved.

Step 5: Anastomosing the Renal Artery and Vein
The renal artery and vein will be anastomosed. The renal vein will be attached to the external iliac vein, usually with a small 5-0 Prolene suture. The artery will be attached to the external iliac artery. The aortic cuff will be trimmed and fitted to the renal artery and then attached to the arteriotomy in the external iliac artery.

Step 6: Reconstructing the Urinary Tract
Now, the urinary tract will be reconstructed. The bladder will be incised, and the patients’ ureter is found. An incision is made in it. The donor ureter will be fed through the incision into the bladder and anastomosed with absorbable suture. The bladder incision is then closed, and the bladder is filled to check for leaks.

Step 7: Closing the Incision
The tissue will be reapproximated and closed with suture.Common sutures used for 5-0 and 6-0 Prolene, 1 and 4-0 PDS, 2-0 and 3-0 silk ties, and #5 Ethibond or Nylon.

Tips and tricks
It’s important to place booties on some mosquitos for clamping suture, and ties should always be available on the sterile field.

The Surgery Sparknotes

  1. Prepare donor kidney by cleaning off fat and shortening vessels.
  2. Place kidney in iliac fossa or retroperitoneum through large incision.
  3. Dissect external oblique muscle and fascia, divide internal oblique and transverse muscles to expose peritoneum, ligate inferior epigastric and preserve spermatic cord.
  4. Anastomose renal artery and vein to external iliac artery and vein using small Prolene suture.
  5. Trim and fit aortic cuff to renal artery and attach it to arteriotomy in external iliac artery.
  6. Reconstruct urinary tract by incising bladder, finding patient’s ureter, making an incision in it, feeding donor ureter through it, and anastomosing it with absorbable suture.
  7. Close bladder incision and check for leaks.
  8. Reapproximate tissue and close with suture.
  9. Use booties for clamping suture and ensure ties are available on the sterile field.

5 thoughts on “Kidney Transplant

    • Joshua Roosevelt says:

      Hi Khushboo,

      Thank you so much for reaching out. This Kidney Transplant setup covers both the recipient and donor side of the procedure. Please let us know if you have any specific questions about the recipient side. We’ll be happy to help and update the setup.

    • Diana Lei-aloha says:

      Hi Alisha, I went ahead and updated the post to include some specific sutures. While it will vary with surgeon’s preference, the most common sutures used during kidney transplants are 5-0 and 6-0 Prolene, 1 and 4-0 PDS, 2-0 and 3-0 silk ties, and #5 Ethibond or Nylon. I recommend checking the surgeon’s preference card for additional sutures.

      Some facilities have dedicated kidney transplants tray, while other use a general trap and vascular tray.

  1. Dr Jyoti P. Deshpande says:

    Information on RENAL TRANSPLANT is useful. I need to know set up of OT for transplant as an anesthesiologist

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