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Kidney Transplant mayo stand and back table surgery setup

Diana Lei-aloha Avatar

setup author

Surgery setup images for Kidney Transplant

Kidney Transplant surgery instruments

Clamping & Occluding instruments

Fogarty Clamp
Fogarty Clamp
Hemostatic Clip Applier
Hemostatic Clip Applier
Debakey Bulldog Clamp
Debakey Bulldog Clamp
Bulldog Clamp
Bulldog Clamp
Curved Hemostat
Curved Hemostat
Right Angle Clamp
Right Angle Clamp
Kelly Forceps
Kelly Forceps
Mosquito Clamp - Curved
Mosquito Clamp – Curved
Tonsil Clamp
Tonsil Clamp
Allis Forceps
Allis Forceps

Cutting & Dissecting instruments

#7 Knife Handle
#7 Knife Handle
#3 Knife Handle
#3 Knife Handle
Potts Smith Scissors
Potts Smith Scissors
Metzenbaum Scissor
Metzenbaum Scissor
Straight Mayo Scissor
Straight Mayo Scissor

Grasping & Holding instruments

Debakey Forcep
Debakey Forcep
Adson Forceps
Adson Forceps
Forester Sponge Forceps
Forester Sponge Forceps

Retracting & Exposing instruments

Bookwalter Retractor
Bookwalter Retractor
Army-Navy Retractor
Army-Navy Retractor
Richardson Retractor
Richardson Retractor

Suctioning instruments

Yankauer Suction
Yankauer Suction

Suturing & Stapling instruments

Ryder Needle Holder
Ryder Needle Holder
Micro Vascular Needle Holder
Micro Vascular Needle Holder
Castroviejo Needle Holder
Castroviejo Needle Holder
Mayo-Hegar Needle Holder
Mayo-Hegar 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 responses to “Kidney Transplant”

  1. khushboo sahani Avatar
    khushboo sahani

    i have requirement KIDNEY TRANSPLANT SET (RECIPIENT PROCEDURE)

    1. 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.

  2. Alisha Avatar
    Alisha

    Can you include which sutures, and trays are used

    1. Diana Lei-aloha Avatar
      Diana Lei-aloha

      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.

  3. Dr Jyoti P. Deshpande Avatar
    Dr Jyoti P. Deshpande

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

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