Once your nephrologist has determined that you will need to begin dialysis you may be referred to our practice where we will then assist you throughout this journey.
You will meet our surgeon who will discuss peritoneal dialysis or hemodialysis, the surgical options and the overall plan for you.
We consider it our duty to you and your loved ones through the initiation of dialysis, maintenance of your access, interventions or any issues that arise with your access. Ultimately, we hope our patients are candidates for, and undergo, successful kidney transplantation.
Our surgical services at the hospital include:
An AV fistula is created when an artery is surgically connected to a vein. An example is a Radial-Cephalic AV Fistula.
The point at which the vessels are connected is called the anastomosis. While a surgeon may create “designer” fistulas, the most common vessels for fisitula creation are the Cephalic or Basilic vein and either the Radial or Brachial artery.
An AV Graft is placed using synthetic tubing, most commonly Gortex, to surgically create a connection between an artery and a vein.
The location of the graft is determined by the surgeon and depends on the patient’s vascular system. Grafts are most frequently connected between a vein and an artery in a patients arm. Thigh grafts are also possible.
We offer options for surgical revision of the AV Fistula/Graft when warranted with the intent of salvaging the existing access.
Peritoneal dialysis- dialysis treatment using the lining of your abdomen, as a filter, and a solution, dialysate to clean waste products from your body.
Through laparoscopic abdominal surgery, a soft tube, called a catheter, is inserted into your abdomen. This tube is used to fill your abdomen with dialysate, then then when the time comes to empty the dialysate and waste products from your abdomen.
What Is Dialysis Access Surgery?
Dialysis is a procedure meant to replicate a patient’s kidney functions when they are in kidney failure. Before dialysis can take place, a patient must first go through a minor operation called dialysis access surgery. This surgery is what allows a connection to be formed between the machine and the patient’s bloodstream.
When Is Dialysis Access Surgery Necessary?
When a patient undergoes dialysis, the current access point could potentially be no longer viable. For example, the vein may collapse, which interferes with the dialysis process. This is where dialysis access surgery comes into play; it is meant to provide a new access point for the blood to be filtered.
Are There Different Types of Dialysis Access Surgery?
Yes, there are three types of dialysis access surgery: home hemodialysis, in-center dialysis, and peritoneal dialysis. All three have their pros and cons, which the surgeon will go over before you make your choice. You can choose what type of dialysis to go on, but depending on your health, some options may not be suitable.
Home hemodialysis is when a patient is hooked up to a machine via two needles inserted into their access point. The blood is then circulated through a dialyzer, also known as an artificial kidney. In-center hemodialysis functions similarly, except it is done within a medical facility rather than at your home. Peritoneal dialysis functions differently; rather than use the veins, an access point is created within the lining of your stomach to act as the filter.
How Long Does Dialysis Access Surgery Take?
Dialysis access surgery takes around one to two hours to complete. Upon completion, patients can usually go home the same day, depending on the current state of their health. The incision can be around two to four inches, so it is not very noticeable.
What Is an Arteriovenous Fistula?
An arteriovenous (AV) fistula is when there is an abnormal connection between a patient’s vein and artery. The blood flows from the arteries into the capillaries and then into the veins. If a person has an AV fistula, the blood will flow directly into the vein and bypass the blood vessels. As a result, the tissues below the capillaries do not receive the necessary amount of blood.
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