Weaving my first thread. Hope it has good ‘tensile strength’ and a lasting ‘memory’.. it’s surgical.🙂The spool is ‘post chemotherapy residual GCT masses.’ The largish ones that encase the renal vessels sparing the parenchyma..like this one 1/6

In 10% of such masses we may end up with vascular injuries/renal ischemia & blood loss,hypotention,inotropes,ATN loop/semi loop & chances of having an R+ resection & catecholamine surges of men & women at work .. or else an elective nephrectomy  2/6

For this patient, we tried different. En-bloc resection of the mass and left kidney to the ice bed with perfusion in place. The perfused, cold kidney was dissected off the mass ‘at the bench’. In the meanwhile the renal vascular stumps back home waited in anticipation 3/6

Friends from Uroonco, Nephrology, anaesthesia & reconstructive sx were partners in prime ..@MayuriTrivedi80 @Nair_Sanj @DrDushyantJ @mayurmantri #vineetpilanya @vinayshankdhar @AmeyaBindu @VandanaChaukar @SheilaMyatra @jigidivatia @MahendraTMH @dramandeeparora @TataMemorial 4/6

The ‘uninvolved’ kidney with its ‘tailored’ vascular hilar ends was autotransplanted orthotopically 5/6

This 23 year old patient was discharged on D10 after resected ‘teratoma’ and a near similar post operative GFR 6/6

Should one go an extra mile salvaging kidneys in #GCT @TestesCancer @AdityaBagrodia @siadaneshmand @tsoburol @uretericbud @anandoncologist @GTumors @usioffice @royalmarsdenNHS @SpiessPhilippe @LoganZemp @TCSociety @YAUpenile_tesCa @NGermCellG @AmitJos98615230 @Amitabh49547601

@VedangMurthy @docpriyamvada @Shrikhande_SV @drsabita @niyogidevayani Excellent Gagan. I am sure this is going to help many more suitable candidates and few of our RP Tumors too.

@VedangMurthy @docpriyamvada @drsabita @niyogidevayani Amazing work!!! You make us proud @TataMemorial

@VedangMurthy @docpriyamvada @Shrikhande_SV @drsabita @niyogidevayani Sensational thread. Clearly a technique to have in the armamentarium for a single kidney / rplnd case. With 2 kidneys, more controversial, but the dissection is beautiful. Keep sharing !

@VedangMurthy @docpriyamvada @Shrikhande_SV @drsabita @niyogidevayani Great to hear from you .. still waiting for journals/platforms that accept open surgeries after I heard your thoughts at #GUcast with @declangmurphy