Video-assisted basilic vein transposition for haemodialysis vascular access: preliminary experience with a new technique.
BACKGROUND
The brachio-basilic vein arteriovenous (AV) fistula is increasingly used as a secondary method for haemodialysis vascular access. The conventional surgical technique of brachio-basilic vein AV fistula creation consists of a long incision with dissection of the basilic vein and transposition of it to a subcutaneous anterior position in the upper arm. The aim of this study was to investigate whether minimal invasive basilic vein dissection with an endoscopic technique is feasible.


METHODS
In 12 patients, brachio-basilic vein AV fistulas were created by means of a video-assisted technique with semi-closed dissection and harvesting of the basilic vein with the use of an endoscope and standard endoscopic instruments. All patients underwent pre- and post-operative duplex ultrasound investigation.


RESULTS
In all patients, a successful endoscopic dissection was possible without peri-operative complications. One patient suffered from post-operative thrombotic occlusion, which was successfully treated by thrombectomy. One patient developed a haematoma in the upper arm. No wound complications occurred and all AV fistulas could be used satisfactorily for dialysis treatment.


CONCLUSIONS
Video-assisted basilic vein transposition is a feasible minimal invasive technique to create secondary vascular access for haemodialysis.
Tordoir
J H
JH
Department of Surgery, University Hospital Maastricht, Maastricht, The Netherlands.
Dammers
R
R
de Brauw
M
M
D000328:Adult; D000368:Aged; D001132:Arm / Q000098:blood supply*; D002408:Catheters, Indwelling; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis; D013525:Surgical Instruments; D014654:Vascular Patency; D014656:Vascular Surgical Procedures; D014680:Veins / Q000601:surgery; D020535:Video-Assisted Surgery