Some of the patients suffering from severe chronic renal failure require dialysis treatment by which a machine helps rid the body from the substances usually disposed of through the kidney.

For a patient to be linked to such a machine, also known as an artificial kidney, and undergo dialysis treatment, it is necessary for a fistula to be created. In most cases this is done in the forearm.

There are two methods for the formation of a fistula for dialysis:

Direct link between an artery and a vein by which creating an arterio-venous fistula
Linking an artery to a vein by means of an artificial pipe, or a graft

סרטון ראיון של המטופלת לאחר ניתוח פיסטולה לדיאליזה

The choice of method for the fistula surgery depends on the anatomical condition of the blood vessels prior to surgery.

Fistula for dialysis surgery is usually not long and can be performed under local anesthesia. Nevertheless, extensive experience and skills are required for vascular surgery on vessels 2 mm in size.

סרטון ניתוח פיסטולה לדיאליזה

Rates of success and adverse effects

The success of such surgery depends on the state of the veins and arteries of the limb prior to surgery. When blood vessels are in good condition the rates of success are high. When blood flow is interrupted or the diameter of vessels is very small the rates of success decrease. And as with any other surgical procedure, there is the risk of bleeding, infection, and nervous damage.

סרטון ניתוח גרפט לדיאליזה

There is also the risk of failure of the procedure and blockage of the area operated on. 5% of patients demonstrate signs of “steal syndrome”, when the flow of arterial blood from the hand towards the venous system can cause functional damage. This situation, when arises, requires additional intervention.

Surgery in preparation for dialysis treatment

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