Comparison of conventional and castroviejo needle holders in terms of vascular anastomosis time in renal transplant

Abstract

Objective: It is important that the anastomosis time of renal vascular structures is not prolonged to minimize the potentially harmful effect of warm and cold ischemic times. This study aimed to determine the effect of the needle holder design used in vascular anastomosis during renal transplantation on the duration of anastomosis.Material and Methods:  Patients that underwent renal transplantation at our clinic between September 2011 and February 2020, were divided into groups according to the two types of needle holders used in anastomoses. In Group 1, a conventional, Hegar-type, straight, 180-mm (7”) Ryder Diadust needle holder was used. In Group 2, a pen-type, straight, 215-mm (8 ½”) Castroviejo Durogrip TC micro needle holder was used. Demographic characteristics, vascular characteristics, and vascular anastomosis times were compared between the two groups. Results: A total of 75 patients were included in the study. There were 39 (52%) patients in Group 1 and 36 (48%) patients in Group 2. The mean number of arteries was 1.2 ± 0.4, and the mean arterial diameter was 5.3 ± 1.2 mm in the whole cohort, with no statistically significant difference between the two groups (p=0.196 and 0.304, respectively). The mean arterial anastomosis time was 15 ± 5.1 minutes in Group 1 and 10 ± 3.9 minutes in Group 2. The mean venous anastomosis times were 18.4 ± 6.1 in Group 1 and 14.7 ± 4 minutes in Group 2. In the statistical analysis, the arterial and vein anastomosis times were found to be significantly shorter in Group 2 than in Group 1 (p=0.038 and p=0.020, respectively).Conclusion: In our study, it was observed that the renal arterial and venous anastomosis times were significantly shorter in the group in which the pen-type Castroviejo needle holder was used in anastomoses performed during renal transplantation.