TnRushFan
Networker
Hey Y'all,
I am coming up a blank with this procedure...any guidance is greatly appreciated.
Patient had aortobifemoral bypass migrate to ureter causing adhesions and ureteral stricture.
My surgeon dissected the structures to separate them then transected the bypass graft passing it under the ureter and anastomosing it back together.
Note Excerpt:
** dissected down to the right retroperitoneum until gaining access to the area where the right limb of the aortobifemoral graft was identified.
** carried this dissection proximally up nearly to the level of the bifurcation of the graft
** did identify a stricture
** gained proximal and distal control of the bypass graft carefully with a combination of blunt and sharp dissection
** graft itself was not compressing the ureter, but rather that the inflammatory action from the Dacron had contributed to some scarring, which had ultimately lead to the stricture and obstruction of the right ureter
** gained proximal and distal control with arteriovascular clamps on the bypass graft and divided the right limb of the bypass graft
** passed it underneath or posterior to the right ureter.
**We then performed an end-to-end anastomosis of the two ends of the bypass graft.
3588[3] is for femoral bypass revision
This isn't a 'new' graft procedure...
Am just at a loss. Thank you in advance.
I am coming up a blank with this procedure...any guidance is greatly appreciated.
Patient had aortobifemoral bypass migrate to ureter causing adhesions and ureteral stricture.
My surgeon dissected the structures to separate them then transected the bypass graft passing it under the ureter and anastomosing it back together.
Note Excerpt:
** dissected down to the right retroperitoneum until gaining access to the area where the right limb of the aortobifemoral graft was identified.
** carried this dissection proximally up nearly to the level of the bifurcation of the graft
** did identify a stricture
** gained proximal and distal control of the bypass graft carefully with a combination of blunt and sharp dissection
** graft itself was not compressing the ureter, but rather that the inflammatory action from the Dacron had contributed to some scarring, which had ultimately lead to the stricture and obstruction of the right ureter
** gained proximal and distal control with arteriovascular clamps on the bypass graft and divided the right limb of the bypass graft
** passed it underneath or posterior to the right ureter.
**We then performed an end-to-end anastomosis of the two ends of the bypass graft.
3588[3] is for femoral bypass revision
This isn't a 'new' graft procedure...
Am just at a loss. Thank you in advance.