| Please accept my warm thanks to the journal ofExperimental and Clinical Transplantation. I thankBrockschmidt and associates for their article,“Minimal access kidney transplant: A noveltechnique to reduce surgical tissue.”1I have somecomments about the article. (1) In this technique, the allograft had been placedextracorporeally, and in this position ananastomosis was performed. Changing theposition of the kidney to place the allograftintracorporeally after anastomosing it led to achance of kinking the vessel, becauseintracorporeally, the distance between the iliacartery and allografted kidney was reduced.(2) The allografted kidney was placed close to thebladder so there was a chance of pressure on theallograft when filling the bladder.(3) In describing anastomosing of the ureter, thewriter described an modified “intravesicular”Lich-Gregoir technique; however, the modifiedLich is “extravesicular” not “intravesicular” (pp323, first column, third paragraph, first line).(4) The authors write that while using this technique,cooling of the allografted kidney is possible. Inany technique for kidney transplant, cooling ofthe allografted kidney is possible eitherintracorporeally or extracorporeally.(5) The authors address by this writing that whenanastomosing the allografted ureter, the paraureterbladder is dissected. In this position, theallografted ureter is closer to the iliac vessel, so thatif there is a complication with the allograftedureter, it can compromise the iliac vessels. |