Laparoendoscopic Single Site Donor Nephrectomy: The Preliminary Experience

Abstract

Methods: In our endeavour to give patients visibly scarless surgery we have raised the bar to the next level in laparoscopic donor nephrectomy. We have moved from standard laparoscopy to LESS Laparoendoscopic single site donor nephrectomy. 1997 we introduced laparoscopic donor nephrectomy in Australia. In September 2008 we did our first LESS donor nephrectomy. September 2008 to October 2009, 6 laparoscopic donor nephrectomies were performed using a single port. Two types of devices have been used R-port and SILS™ Port. The device was inserted through an intra umbilical incision using open technique. Surgical technique was similar to the laparoscopic method and standard rigid and roticulator laparoscopic instruments were used. Results: All were completed with no major complications. In 3 an additional 5 mm port was added to reduce the dissection time. Average operating time was 4.4 hours, warm ischemia time was an average of 7.16 minutes and post surgery hospital stay was an average of 1.41 days. All grafts functioned immediately after transplantation. Conclusion: Initial experience with this technique is promising. It is too early to draw any conclusions on its benefits to the donor in terms of reduced morbidity. However the donors appreciated the cosmesis. It is yet another learning curve for the transplant surgeon.