The smallest (to my knowledge) single incision basilic vein transposition. First one I’ve ever done…usually I make 2 incisions but felt like being a little crazy and was able to complete it with just one.
@TransplantSrgn That was about 4 cars ago. Since then I’ve had a Maybach, a G63 4x4 squared, a Bentley Bentayga Speed, and now my daily is the Black Badge RR Cullinan😂
@TransplantSrgn@robshahverdyan@NMawlaMD@jflucas3@wasse_m I don’t do “lifts.” The vein never stays there no matter how you close the pocket. Creating a new tunnel ensures the vein stays superficial throughout the course of the cannulation zone. I’ve actually never done a lift but I see other surgeon’s work and the patients hate it.
@TransplantSrgn@robshahverdyan@NMawlaMD@jflucas3@wasse_m I performed a new tunnel…transected the vein, passed it through the tunnel, and re-anastomosed it at the juxta segment end to end. Her skin laxity allowed me to get the tunnel far up into the axilla. Wouldn’t have been able to do this on a skinny patient.
@wasse_m @BrouwerMaier @VASAMD@ASDINNews@NMawlaMD@robshahverdyan@jwynn9154 I’ve never not been able to re-tunnel a wide open basilic vein. Although that’s the nicest superficialization I’ve ever seen I still hate that long scar. I suspect cannulation will be difficult, just avoid thru and thru sticks close to the elbow.
@robshahverdyan@wasse_m@ASDINNews@VASAMD@CKeithOzaki@NMawlaMD Haha just me and my assistant and a long Richardson retractor. The confluence of the basilic and brachial veins can get a little harrowing and I’m not afraid to make another incision between the two shown there if I can’t see well enough. I love me some branchless basilics tho😂
@wasse_m@robshahverdyan@ASDINNews@VASAMD@CKeithOzaki@NMawlaMD 17 years ago, when I decided to limit my practice to HD access, I went out to the units and spent time with the techs and nurses. Figured if I made their lives easier, your life would be easier, the patients’ lives would be easier, and I’d get all the business. Life is good🌟👌