The Efficiency of Laparoscopic Splenorenal Shunt: a Chronic Canine Model.
10.4111/kju.2006.47.3.316
- Author:
Ki Soo LEE
1
;
Gyung Tak SUNG
Author Information
1. Department of Urology, Dong-A University School of Medicine, Busan, Korea. sunggt@daunet.donga.ac.kr
- Publication Type:Original Article
- Keywords:
Splenorenal shunt;
Animal model;
Laparoscopy
- MeSH:
Animals;
Drainage;
Euthanasia;
Follow-Up Studies;
Hemorrhage;
Intraoperative Complications;
Kidney;
Laparoscopy;
Models, Animal;
Operative Time;
Renal Artery;
Renal Artery Obstruction;
Splenic Artery;
Splenorenal Shunt, Surgical*;
Sutures;
Thrombosis;
Ultrasonography;
Urography
- From:Korean Journal of Urology
2006;47(3):316-321
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Splenorenal bypass is a major surgical procedure that's used for the management of renal artery stenosis. Herein, we evaluate the feasibility and efficacy of performing laparoscopic splenorenal bypass in a chronic canine model. MATERIALS AND METHODS: A total of 12 animals were used for this study. The initial 6 acute animals were used to develop the technique. The remaining 6 surviving animals, which form the basis for this report, were used for a chronic study with up to 2 months follow-up. The renal artery and the distal splenic artery was dissected, its proximal end clamped and its distal end cut and spatulated. An end-to-end anastomosis of the splenic artery and renal artery was performed using only laparoscopic freehand suturing and knot-tying techniques. Upon revascularization, a laparoscopic doppler ultrasound probe was used to document blood flow in the renal artery. Three animals were each followed for 1 month and 2 months, respectively. RESULTS: The total operative time was 297+/-36 min. The mean number of suture bites per anastomosis was 14.3. The only intraoperative complication was hemorrhage from the anastomotic site. Intraoperative Doppler ultrasound documented good blood flow in all 6 animals upon releasing the clamp. At the time of euthanasia, intravenous pyelography (IVP) showed early visualization of the left kidney with prompt drainage in 5 of the 6 surviving animals. In one animal that had two left renal arteries, a distal thrombosis was found despite the patent anastomotic site. CONCLUSIONS: Laparoscopic splenorenal bypass can be performed in a reproducible fashion with using only intracorporeal techniques. We believe that with experience, complex urologic vascular procedures can be laparoscopically performed in the future.
