Is right laparoscopic donor nephrectomy right?

Sawatzky, Mark; Ellsmere, James; Klassen, Dennis; Walsh, Mark; Molinari, Michele; Nashan, Björn; Bonjer, Jaap

doi:10.1007/s00464-008-0158-8

Cited by 11 publications

(5 citation statements)

References 18 publications

(38 reference statements)

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“…Compared to the large published series of (hand-assisted) laparoscopic nephrectomies, the RPDN operation time was clearly shorter [4,19,20], demonstrating that RPDN is relatively easy to perform. The clear view onto renal vessels provides a safe procedure for left-and right-sided kidney donation.…”

Section: Discussionmentioning

confidence: 81%

Comparing Surgical Complications of Donors and Recipients in Retroperitoneoscopic versus Mini-Incision Donor Nephrectomy: A Single-Center Experience

Koch

Bachmann

Nashan

2013

ISRN Transplantation

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Anterior vertical mini-incision donor nephrectomy (MIDN) has been used as the standard retrieval procedure in our center. Though the MIDN approach was tolerated very well with low complication rates, there were especially cosmetic reasons, to consider a change of procedure. Hence we switched to a total retroperitoneoscopic donor nephrectomy (RPDN) in 2011. We compared the outcome and surgical complications of donors and recipients of the first 30 RPDNs performed with 30 consecutive MIDN procedures. In both techniques, right and left nephrectomies were carried out. After a very short learning curve, the mean RPDN operation times were shorter compared to the MIDN (109 versus 171 min, < 0.01) and donors were discharged earlier. No major complications occurred in the RPDN group and complications were less frequent compared to MIDN (17% versus 40%). The renal function in the recipients was equivalent in both groups at the time of discharge and after one year. We conclude that RPDN is easy to learn for a surgical team experienced in open retroperitoneal donor nephrectomy. The change of the retrieval technique is safe for the donor and the recipient regarding surgical complications and recipients' renal function. Donors benefit from RPDN due to earlier hospital discharge and faster recovery.

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Section: Discussionmentioning

confidence: 81%

Comparing Surgical Complications of Donors and Recipients in Retroperitoneoscopic versus Mini-Incision Donor Nephrectomy: A Single-Center Experience

Koch

Bachmann

Nashan

2013

ISRN Transplantation

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“…described worse outcome for right kidneys, with significantly more renal vein thrombosis. One RCT, one prospective and five retrospective studies concluded that right sided‐donor nephrectomy is also justified, and some studies even indicate the superiority of the right side [72–78] (level 1b evidence) (Table 3).…”

Section: Resultsmentioning

confidence: 99%

Live donor nephrectomy: a review of evidence for surgical techniques

Dols

Kok

IJzermans

2010

Transplant International

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Summary Live kidney donation is an important alternative for patients with end‐stage renal disease. To date, the health of live kidney donors at long‐term follow‐up is good, and the procedure is considered to be safe. Surgical practice has evolved from the open lumbotomy, through mini‐incision muscle‐splitting open donor nephrectomy, to minimally invasive laparoscopic techniques. There are different minimally invasive techniques, including standard laparoscopic, hand‐assisted laparoscopic, hand‐assisted retroperitoneoscopic, pure retroperitoneoscopic, and robotic‐assisted live donor nephrectomy. At present, these minimally invasive techniques are subjected to clinical trials focusing on surgical outcome, quality of life, costs, long‐term follow‐up, and also morbidity of donor, recipient, and graft. In practice, many centers only perform donor nephrectomy on young healthy donors with normal weight. There is increasing evidence that donor nephrectomy with multiple arteries, right kidney and obese patients can be done with precaution. In this review, we address the surgical part of live kidney donation and the best level of evidence for all surgical techniques and issues surrounding the technique.

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“…Keller et al reported that 36 right-sided procedures out of 230 LDNs showed similar results in EBL, amount of blood transfusion, operative time, LOS, and delayed graft function compared with left-sided HALDN [20]. There have been more reports about the excellent surgical outcomes of right laparoscopic donor nephrectomy compared with left-sided operations [21-23]. …”

Section: Discussionmentioning

confidence: 99%

Hand-Assisted Laparoscopic Right Donor Nephrectomy: Safety and Feasibility

et al. 2010

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PurposeWe aimed to prove the safety and feasibility of right-sided hand-assisted laparoscopic donor nephrectomy (HALDN).Materials and MethodsBetween May 2006 and May 2009, 16 patients underwent right-sided HALDN at our institution. Of these patients, 15 showed significantly lower renal function in the right kidney than in the left one and 1 had a stone in the right kidney. When the right renal vein was divided, an EndoGIA stapling device was placed on the wall of the inferior vena cava to gain a maximal length of the vein. We evaluated intraoperative and postoperative parameters such as operative time, delivery time, warm ischemic time, estimated blood loss, intraoperative and postoperative complication rates, length of hospital stay, and serum creatinine levels of donors (at the time of discharge) and recipients (4 weeks postoperatively), comparing the right-sided HALDN group (our study) with a left-sided HALDN group (from a previously reported study).ResultsA total of 16 right-sided HALDNs were successfully performed without any complications or open conversion. All of the intraoperative and postoperative parameters were similar between the right-sided HALDN and left-sided HALDN groups. There were no technical problems in the recipients in the anastomosis of the renal vein, and the ureteral anastomoses were also successful.ConclusionsRight-sided HALDN is safe and technically feasible in a donor, showing favorable graft outcomes. The results of our study suggest that right-sided HALDN may be preferable in patients with significantly lower renal function in the right kidney than in the left one.

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Is right laparoscopic donor nephrectomy right?

Cited by 11 publications

References 18 publications

Comparing Surgical Complications of Donors and Recipients in Retroperitoneoscopic versus Mini-Incision Donor Nephrectomy: A Single-Center Experience

Comparing Surgical Complications of Donors and Recipients in Retroperitoneoscopic versus Mini-Incision Donor Nephrectomy: A Single-Center Experience

Live donor nephrectomy: a review of evidence for surgical techniques

Hand-Assisted Laparoscopic Right Donor Nephrectomy: Safety and Feasibility

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