title: A surgical technique using the ovarian vein in non-human primate models of potential living-donor surgery of uterus transplantation.
abstract: OBJECTIVE
  Living donor surgery in organ transplantation should be performed in a minimally invasive manner under conditions that are as safe as possible. The objective of this study is to examine whether the procedure for using the ovarian vein makes donor surgery less invasive in a cynomolgus monkey model of potential living-donor surgery of uterus transplantation.
  
  
  METHODS
  Twenty-two female cynomolgus monkeys aged 6-9 years and with body weights of 3.55 ± 1.28 kg were used in the study. Vessels and tissues surrounding the uterus were dissected while preserving the uterine artery/vein. The deep uterine vein was used as a venous pedicle in four monkeys (Group 1), and the ovarian vein was used instead of the deep uterine vein in 18 monkeys (Group 2). With the uterine artery/vein and deep uterine vein (Group 1) or ovarian vein (Group 2) connected to the uterus, the vaginal canal was cut. The vessels were then clamped to produce a donor surgery model. Surgical time, intraoperative organ and vascular injury were examined in each animal.
  
  
  RESULTS
  The average surgical time from laparotomy to clamping of vessels was 230 ± 112 min in all 22 cynomolgus monkeys, and significantly longer in Group 1 (n = 4) than in Group 2 (n = 18) (393 ± 71 vs. 194 ± 84 min, p < 0.05). Surgical time in Group 2 showed a tendency to decrease in animals treated later in the study, with a significantly longer time in the first 10 monkeys compared with the last 8 (253 ± 65 vs. 120 ± 26 min, p < 0.05). All monkeys had no complications, including no injuries to other organs and no unanticipated vascular injury.
  
  
  CONCLUSIONS
  The procedure using the ovarian vein was less invasive than that using the deep uterine vein in mimicking living-donor surgery in a cynomolgus monkey model of uterus transplantation.
authors.affiliation: Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Iori
authors.initials: I
authors.lastname: Kisu
authors.affiliation: Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Kouji
authors.initials: K
authors.lastname: Banno
authors.affiliation: Department of Vascular Surgery, Saiseikai General Hospital, Saitama, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Mihara
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduates School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Hisako
authors.initials: H
authors.lastname: Hara
authors.affiliation: Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Umene
authors.affiliation: Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Adachi
authors.affiliation: Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Yuya
authors.initials: Y
authors.lastname: Nogami
authors.affiliation: Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Aoki
mesh_terms: D000818:Animals; D004210:Dissection / Q000379:methods; D005260:Female; D007044:Hysterectomy / Q000379:methods*; D008252:Macaca fascicularis; D023421:Models, Animal; D061646:Operative Time; D010053:Ovary / Q000098:blood supply*; D020858:Tissue and Organ Harvesting / Q000379:methods*; D055988:Uterine Artery; D014599:Uterus / Q000637:transplantation*; D014680:Veins
keywords: Cynomolgus monkey; donor surgery; invasive surgery; uterine factor infertility; uterus transplantation