Caval extension of the right renal vein in cadaveric renal transplantation using the ETS 45 endoscopic stapler.

A major technical difficulty encountered with the transplantation of a cadaveric right kidney is due to the short right renal vein. The transplant surgeon usually has two different options to deal with this: the first is to mobilize the external iliac vein, ligating the internal iliac vein and the small retroiliac veins, while the second option is to increase the length of the right renal vein. Right renal vein extension is usually preferred because it is easier to work with. The technique used was to construct a conduit with the vena cava that extends the cadaveric right renal vein using an endoscopic stapler (Ethicon Endopath Linear Cutter ETS45, cod. TSW 45) for thin/vascular tissues. This procedure has been used successfully in 11 of our 155 transplanted patients. We have seen no vascular complications as a result of the stapled conduit of the vena cava. We conclude that the endoscopic stapler for thin/vascular tissues is safe and easy to use in right renal vein extension.