First Prize: Standard Laparoscopic Donor Nephrectomy Versus Laparoendoscopic Single-Site Donor Nephrectomy: A Randomized Comparative Study

Abstract

In this select group of donors, LESS donor nephrectomy, although challenging to the surgeon with longer warm ischemic times, gave early pain relief with shorter hospital stay and comparable graft function.

Surgical Advances in Laparoscopic Donor Nephrectomy

“…Other smaller, single center series have demonstrated similar outcomes comparing laparoendoscopic single site donor nephrectomies to conventional laparoscopic donor nephrectomies [26,27]. Kurien and colleagues reported the first randomized controlled trial of 50 patients comparing conventional laparoscopic donor nephrectomies versus laparoendoscopic single-site donor nephrectomies [28]. They reported an intraoperative and postoperative complication rate of 16% in the laparoendoscopic single-site donor group, which was similar to the conventional laparoscopic donor nephrectomy group.…”

“…Comparisons of early and late allograft function in the recipient of open versus conventional laparoscopic donor nephrectomy have already been shown in several studies, including two randomized controlled trials [35,36]. Similarly, all recent studies comparing allografts procured with the laparoendoscopic single site technique have shown similar early allograft function compared to allografts via conventional laparoscopic approaches [10][11][12]28]. Moreover, these results have also been seen with right sided allografts, despite the shorter vasculature when compared to either right or left allografts [19,30].…”

“…They did however identify superior patient scar satisfaction, decreased oral analgesic use, and improved convalescence in the laparoendoscopic single site cohort. Kurien and colleagues demonstrated no difference in convalescence parameters in their randomized controlled trial comparing 25 laparoendoscopic single site donor nephrectomies to 25 conventional laparoscopic donor nephrectomies [28]. The laparoendoscopic cohort did have less pain requirements and a one-half day improvement in hospital stay; however, the warm ischemia time was slightly increased in that cohort.…”

Laparoendoscopic Single Site Donor Nephrectomy: The Preliminary Experience

“…It is a new learning curve to master this method. There may be a need to have an additional 5 mm port or a needlescope especially during the early experience as we and others [5,9,10] have done. With experience the need for this additional port/needle scope diminishes.…”

“…The post surgery hospital stay was a mean of 1.83 ± 0.4 days. Worldwide experience with this technique for donor nephrectomy is limited [9,11]. Laparoscopic method of donor nephrectomy has reduced the postoperative morbidity and hospital stay.…”