Challenges in laparoscopic donor nephrectomy and technical innovations to make it cost effective

A Systematic Review of Laparoscopic Live-Donor Nephrectomy

“…In LLDN patients, rates between 2% (11,34) and 30% (6,36) were reported; in OLDN patients, rates between 3% (34) and 44% (47) were reported. There was no statistically significant difference between LLDN and OLDN patients in the two studies that reported significance (35,43).…”

“…A zero rate for LLDN was reported in seven studies (9,10,12,33,35,39,40) and for OLDN in five studies (10,12,33,39,40). Rates for LLDN in the other studies ranged from 2% (41,46) to 31% (23).…”

“…There was no statistically significant difference between LLDN and OLDN patients in the two studies that reported significance (17,34). Acute rejection episodes: Acute rejection episodes were reported in 16 comparative studies (6, 7, 9, 11, 18, 24, 33-36, 38, 40, 41, 43, 45, 47), only two of which reported statistical significance (35,43). In LLDN patients, rates between 2% (11,34) and 30% (6,36) were reported; in OLDN patients, rates between 3% (34) and 44% (47) were reported.…”

“…Conversion rates ranged from 0% in 11 studies (14, 26, 39, 40 -42, 44, 47) to 13.3% (33). Reasons for conversion included vascular complications in 21 cases, perioperative bleeding in 11 cases, mechanical complications in 14 cases (including 6 cases of splenic capsule injury), and hemorrhage in 6 cases (11,13,18,19,25,26,28,30,32,33,35,37,38,42,44,45).…”

Laparoscopic v Open Donor Nephrectomy: A Cost-Utility Analysis of the Initial Experience at a Tertiary-Care Center

“…In addition, laparoscopic procedures employ a number of (expensive) disposable surgical instruments not needed in open procedures. 29,35 While there are some hospital savings from earlier discharge, LapDN hospital costs remain greater. However, these costs may be partially or completely offset by potential societal savings from a more rapid return to work postoperatively in LapDN patients.…”