■盆腔器官的多内脏移植将是严重盆底功能障碍伴大便和尿失禁的潜在治疗方法,会阴广泛性创伤,或先天性疾病。这里,我们描述了盆腔器官多内脏移植的显微外科技术,包括骨盆底,在老鼠
■我们进行了会阴(包括生殖器,肛门,肌肉,和韧带)和腹部切口。解剖在骨盆环附近进行,分裂韧带,肌肉,髂外血管,和阴部神经,允许盆底动员。主动脉和腔静脉在远端隔离,保留髂内和性腺血管。含有皮肤的移植物,肌肉,韧带,膀胱,输尿管,直肠,肛门和阴道,子宫和卵巢(女性),或者阴茎,睾丸及其导管(男性)被全部移除,flushed,冷藏。
■分离肾下主动脉和腔静脉,并进行供体/受体主动脉-主动脉和腔静脉端对侧微吻合。盆底和内脏切除后,我们在供体和受体输尿管之间进行了微吻合,还有直肠和阴部神经.将盆底重新定位在其原始位置(原位模型)或腹壁(异位模型)。我们在手术后2小时处死动物。
■我们进行了7次原位和4次异位移植。来自原位模型的一只动物和来自异位模型的一只动物由于技术故障而死亡。6名原位和3名异位受体在移植后2小时内存活。
■大鼠盆底移植的显微外科技术是可行的,早期生存率为81.82%。
UNASSIGNED: Multivisceral transplantation of pelvic organs would be a potential treatment for severe pelvic floor dysfunction with fecal and urinary incontinence, extensive perineal trauma, or congenital disorders. Here, we describe the microsurgical technique of multivisceral transplantation of pelvic organs, including the pelvic floor, in rats.
UNASSIGNED: We performed a perineal (including the genitalia, anus, muscles, and ligaments) and abdominal incision. The dissection progressed near the pelvic ring, dividing ligaments, muscles, external iliac vessels, and pudendal nerves, allowing pelvic floor mobilization. The aorta and vena cava were isolated distally, preserving the internal iliac and gonadal vessels. The graft containing the skin, muscles, ligaments, bladder, ureter, rectum, anus and vagina, uterus and ovarian (female), or penile, testis and its ducts (male) was removed en bloc, flushed, and cold-stored.
UNASSIGNED: The infrarenal aorta and vena cava were isolated and donor/recipient aorta-aorta and cava-cava end-to-side microanastomoses were performed. After pelvic floor and viscera removal, we performed microanastomoses between the donor and the recipient ureter, and the rectum and pudenda nerves. The pelvic floor was repositioned in its original position (orthotopic model) or the abdominal wall (heterotopic model). We sacrificed the animals 2 h after surgery.
UNASSIGNED: We performed seven orthotopic and four heterotopic transplantations. One animal from the orthotopic model and one from the heterotopic model died because of technical failure. Six orthotopic and three heterotopic recipients survived up to 2 h after transplantation.
UNASSIGNED: The microsurgical technique for pelvic floor transplantation in rats is feasible, achieving an early survival rate of 81.82%.