Navegando por Palavras-chave "Hemostasia cirúrgica"

Agora exibindo 1 - 1 de 1
  • Imagem de Miniatura
    Item
    Acesso aberto (Open Access)
    The boatman's knot: a new option for renal hilum ligation during laparoscopic nephrectomy
    (Sociedade Brasileira para o Desenvolvimento da Pesquisa em Cirurgia, 2005-06-01) Bomfim, Alexandre C. [UNIFESP]; Andreoni, Cássio [UNIFESP]; Miotto, Ari [UNIFESP]; Araújo, Mardhen B. [UNIFESP]; Ortiz, Valdemar [UNIFESP]; Poli de Figueiredo, Luiz Francisco [UNIFESP]; Srougi, Miguel [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    PURPOSE: The authors present and describe an original adaptation for the use of boatman's knot in renal vein ligation during laparoscopic nephrectomy. This procedure may replace the need for the endovascular stapler, which is considered the standard of care, but not available in several institutions in Brazil. The knot presented is also known as thepig's knot in several farms in Brazil. METHODS: Fourteen laparoscopic nephrectomies were performed by the same surgeon in a standard fashion in seven female pigs. Both the renal artery and vein were ligated using the boatman's knot as the only method for hemostasis with conventional intracorporeal technique. Two knots were applied in each artery and vein; one knot was tied proximally and the other distally. The vessels were then sectioned in between both knots. This technique is based on the intracorporeal confection of two loops by the right hand pair of dissectors with the help of the left hand. The arteries and the veins were then sectioned and the capability to accomplish full hemostasis was observed. RESULTS: All the laparoscopic nephrectomies were performed successfully. The boatman's knot was performed by the same surgeon with neither complications nor difficulties during the confection of the knot. In all cases hemostasis was fully achieved using only the boatman's knot as the hemostatic method. CONCLUSION: The boatman's knot is feasible and safe for hilum control during laparoscopic nephrectomy in pigs and total hemostasis can be achieved using it as the only method of hemostasis. However, the safety and the capacity of others to learn how to apply it should be tested before it may be advised to use it routinely.