Lipectomy Technique as a Second-stage Procedure for Primarily Matured, Deep Outflow Vein in Obese Individuals

Indian Journal of Nephrology
L SułkowskiA Pasternak

Abstract

Prevalence of obesity is growing in the general population as well as among end-stage renal disease (ESRD) patients requiring dialysis. Obesity often leads to a situation when a mature outflow vein is located deeper than 6 mm and is difficult to cannulate. These obese patients usually require additional procedures to able to successfully cannulate the fistula. The available surgical options include: outflow vein elevation, liposuction, and lipectomy. We present a case of a 57-year-old obese female with ESRD and matured, deeply running, inadequate for cannulation arteriovenous fistula. We present a technique of lipectomy with wide resection of adipose tissue from superior and lateral surfaces of outflow vein. Postoperatively, the skin without the underlying adipose tissue collapses allowing easy cannulation of the long segment of outflow vein with two needles. Lipectomy of mature but deeply located outflow vein is a second-stage elective procedure. Wide resection of adipose tissue helps create easy to access cannulation zone in obese individuals.

Methods Mentioned

BETA
dissection

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.