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Background <p>The proportion of obese individuals is particularly high in the population of patients requiring dialysis and is continuously increasing. Although the conditions for creating an arteriovenous (AV) fistula can initially seem to be challenging, the outcome of the AV fistulas created is surprisingly good. The shunt vein, which is often positioned too deep for safe puncture, must be superficialized in a&#xa0;second step. The techniques used so far are sometimes complex surgeries involving large incisions and wounds.</p> Method <p>This article presents our no-touch technique, which we have used to treat 140 patients over a&#xa0;period of 7.5&#xa0;years. With the minimally invasive ultrasound-guided lipectomy (MISLE), the shunt vein is left entirely within its tissue connection and the subcutis between the skin and subfascial tissue is removed.</p> Results <p>Using this method 96% of the patients on dialysis examined could be successfully punctured at the treated puncture site after healing. The surgical complication rate was 2.9%.</p> Conclusions <p>Minimally invasive ultrasound-guided lipectomy is a&#xa0;safe, minimally traumatic and successful procedure for superficializing the cephalic vein in the forearm and upper arm as a&#xa0;vascular access vein.</p>

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Die minimal-invasive sonographisch geführte Lipektomie zur Superfizialisierung der V. cephalica als Shuntvene

  • 期刊论文

  • 发表日期：

    2025年11月6日

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  • Isabell Jester

摘要

Background

The proportion of obese individuals is particularly high in the population of patients requiring dialysis and is continuously increasing. Although the conditions for creating an arteriovenous (AV) fistula can initially seem to be challenging, the outcome of the AV fistulas created is surprisingly good. The shunt vein, which is often positioned too deep for safe puncture, must be superficialized in a second step. The techniques used so far are sometimes complex surgeries involving large incisions and wounds.

Method

This article presents our no-touch technique, which we have used to treat 140 patients over a period of 7.5 years. With the minimally invasive ultrasound-guided lipectomy (MISLE), the shunt vein is left entirely within its tissue connection and the subcutis between the skin and subfascial tissue is removed.

Results

Using this method 96% of the patients on dialysis examined could be successfully punctured at the treated puncture site after healing. The surgical complication rate was 2.9%.

Conclusions

Minimally invasive ultrasound-guided lipectomy is a safe, minimally traumatic and successful procedure for superficializing the cephalic vein in the forearm and upper arm as a vascular access vein.