The Evolution of Laparoscopic Right Donor Nephrectomy: Progression to Single Site Surgery
- *Corresponding Author:
- Del Pizzo JJ
Department of Urology
New York-Presbyterian Hospital
Weill Cornell Medical College, New York, USA
525 East 68th St. Starr 900 New York 10065, USA
Tel: (212) 746-5250
Fax: (212) 746-0412
E-mail: [email protected]
Received Date: August 09, 2011; Accepted Date: November 14, 2011; Published Date: November 18, 2011
Citation: Afaneh C, Ramasamy R, Aull MJ, Leeser DB, Sosa RE, et al. (2011) The Evolution of Laparoscopic Right Donor Nephrectomy: Progression to Single Site Surgery. J Transplant Technol Res 1: 103. doi: 10.4172/2161-0991.1000103
Copyright: © 2011 Afaneh C, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Laparoscopic donor nephrectomy represents a significant source of allografts to patients with endstage renal disease. Given the increasing wait-list and limited number of deceased donors, utilization of the right kidney is necessary to maximize the donor pool.
Materials: We retrospectively reviewed 122 right-sided kidney donors; 73 hand-assisted laparoscopic donor nephrectomies (R-HAL-DN), 36 standard laparoscopic donor nephrectomies (R-LAP-DN), and 13 laparoendoscopic single site donor nephrectomies (R-LESS-DN). We compared these groups to matched left donors and each other, analyzing various parameters including operative times, warm ischemia time (WIT), estimated blood loss (EBL), incision length, length of stay (LOS), convalescence data and complications.
Results: Right and left donors demonstrated no difference in analysis parameters in all 3 procurement techniques. When comparing all right donors total operative time and allograft extraction time were lowest in the R-LAP-DN group (p=0.003 & p=0.04, respectively). The R-LESS-DN group had the lowest EBL (p=0.06) and shortest incision length (p<0.0001). The LOS was shortest in the R-LAP-DN group (p=0.03). WIT, donor convalescence, and recipient allograft function were similar in all 3 groups.
Conclusion: Our data demonstrates the safety and reproducibility of procuring the right kidney. Donor safety and allograft function have continued through evolution of the technique.