Hand-Assisted Laparoscopic Live Donor Nephrectomy (Right-Sided Approach): Experience Obtained From 31 Cases

• Published in: Transplantation proceedings Vol. 39; no. 8; pp. 2476 - 2477
• Main Author: Maciel, R.F
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Elsevier Inc 01-10-2007; Elsevier Science
• Subjects: Biological and medical sciences; Blood Loss, Surgical; Digestive system. Abdomen; Diuresis; Endoscopy; Follow-Up Studies; Functional Laterality; Fundamental and applied biological sciences. Psychology; Fundamental immunology; Humans; Investigative techniques, diagnostic techniques (general aspects); Kidney Transplantation - physiology; Laparoscopy - methods; Living Donors; Medical sciences; Nephrectomy - methods; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the urinary system; Tissue and Organ Harvesting - methods; Tissue, organ and graft immunology; Human; Endoscopic surgery; Living donor; Sudden death; Right; Infant; Laparoscopy; Transplantation; Hand assisted laparoscopic surgery; Kidney; Case study; Medicine; Experience; Treatment; Urinary system; Nephrectomy; Graft; Surgical approach; Endoscopy; Organ harvesting
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2007.07.031

Abstract Introduction The removal of a donor kidney by laparoscopic nephrectomy is a safe method that is widely used, mainly in left donor nephrectomy. However, for right donor nephrectomy where the right renal vein is short, open surgery has been more frequently described in the literature. Objective Our objective was to describe our experience with 31 renal transplantations using 2 different techniques in right donor nephrectomy. Method In the period ranging from February 2002 to June 2005, we performed, 31 hand-assisted laparoscopic right donor nephrectomies. Twenty-five were performed by the method where the assistant used his hand to assist the surgery and 6 were by the laparoscopic method assisted by the first surgeon. Results The right donor nephrectomies assisted either by the hand of the assistant or the surgeon showed similar results. All recipients displayed diuresis in the immediate postoperative period. The serum creatinine level at 1 week after transplantation was 1.90 mg/dL (±1.55). Conclusion Although the handling techniques are similar, we concluded that laparoscopic nephrectomy assisted by the surgeon is more adequate for right kidney extraction. It can be performed either by a resident doctor or a surgeon of the transplantation team, with or without experience in nephrectomy for transplantation.