Kidney Matters - Issue 10 Autumn 2020

“A functioning arteriovenous
fistula that is also almostinvisible
to the naked eye!”
25
An AV fistula
with you then the word gets out and other patients in
other units will request this surgery. This is the only
way a new technique gains traction and becomes an
accepted process.
On day one, we had two patients on our list. One of the
experts joined us in theatre to oversee proceedings.
The technique is quite amazing. The person is not put
to sleep to undergo the procedure and it takes a similar
amount of time to open surgery. But we expect the
time the surgery takes to decrease quite substantially.
We numb the patient’s arm and the actual formation
of the fistula takes only a few minutes. The patient
remains fully awake. Then, like standard AV fistula
surgery, we scan the newly formed Endo AV fistula
immediately to check that the blood is flowing and
confirm that the surgery has been successful.
Another big plus for the patient is the realisation that
the only scarring they will be left with are two or three
tiny needle holes – the size of the end of a dialysis
needle. This means there is no restriction on moving
the arm, no need for heavy bandages and no need for
much, if anything, by way of pain relief afterwards.
In fistula surgery, we talk about two types of outcome;
one is ‘flow outcome’ and the other is ‘functional
outcome’. With an Endo AV fistula, the flow happens
immediately after the surgery is completed, and the
functional outcome sees the patient potentially able to
use the fistula as access for dialysis from two weeks.
Ask for the surgery
I would say to any patient in the UK who wants this
surgery to ask their renal team for it. As a Endo-AVF
team based in London, we are very keen to share this
expertise and if that means travelling to your hospital
to support your teams, we can arrange to do that.
Just ask the question!
Issue 10 | Autumn 2020