Extraction Sites

Suprapubic, umbilical, lower quadrant, and dorsal lumbotomy extractions all have been performed, and there are only minor differences in discomfort and recovery between these sites. At the time of this writing, transvaginal extraction has not yet been performed. It is hard to imagine any further improvements in outcome with alternative extraction sites because of the size requirement to remove the kidney.

The best site to extract the graft is through an infraumbilical midline or Pfannenstiel incision. Port site hernias may occur and are more common for the larger ports with cutting blades.

Extraction site hernias are fortunately uncommon. They are more likely to occur if an umbilical site or lateral abdominal wall sites are used.

The best site to extract the graft is through an infraumbilical midline or Pfannenstiel incision. Port site hernias may occur and are more common for the larger ports with cutting blades.

Sixty percent of the vascular injuries requiring open conversion occur during the use of the endovascular stapler. Therefore, complete dissection prior to use and great care in avoiding other clips and staples when applying the endovascular staplers are essential. With major vascular injuries, quick conversion will minimize blood loss and maximize the chances for a successful outcome for both the donor and the recipient.

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