Minimally invasive donor nephrectomy: current state of the art

Shockcor, Nicole; Sultan, Samuel; Alvarez-Casas, Josue; Brazio, Philip S.; Phelan, Michael W.; LaMattina, John C.; Barth, Rolf N.

doi:10.1007/s00423-018-1700-3

Cited by 24 publications

(12 citation statements)

References 75 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…None of our cases had conversion to open surgery. [4,5] Laparoscopic donor nephrectomy shortened the length of hospital stay. Although the patients were medically ready for discharge on the second day, the length of hospitalization was longer in our patients The median length of hospital stay was 5 days.…”

Section: Discussionmentioning

confidence: 99%

Extraction of Kidney via Suprapubic or Inguinal Incision in Total Laparoscopic Donor Nephrectomy

Sümer¹

2019

Laparosc Endosc Surg Sci

View full text Add to dashboard Cite

Introduction: The objective of this study was to investigate the results of the first 48 patients who underwent total laparoscopic transperitoneal donor nephrectomy at a single institution and to present the impact of the kidney extraction site on ischemia time. Materials and Methods: The study included patients who underwent kidney donor surgery between February 2017 and December 2018. Evaluation of the kidney transplantation candidates was performed by the kidney transplantation council. A total of 4 trocars were used for a right-side nephrectomy, and 3 trocars were used for a left-side nephrectomy. The kidneys were extracted through a suprapubic incision in the first 18 cases and through the inguinal region in the last 30 cases. A comparison was made of the demographic characteristics and the intraoperative and postoperative results of the 2 groups. Results: Of the study patients, 30 were female and 18 were male, with a mean age of 48.0±9.6 years (range: 30-71 years). All of the patients underwent a total laparoscopic transperitoneal donor nephrectomy. Four patients underwent a right-side nephrectomy and 44 underwent a left-side nephrectomy. There was no case of conversion to open surgery. The mean operative time was 251.4±72.4 minutes (range:127-420 minutes). In the first 18 cases, the organ was extracted through a suprapubic incision and the ischemia time was 318±140 seconds (range: 150-720 seconds). In the last 30 cases, the organ was extracted through an inguinal incision and the mean ischemia time was 151.5±55.1 seconds (range: 80-265 seconds). The mean length of hospital stay was 5.4±1.1 days (range: 3-10 days). Conclusion: The application of minimally invasive surgery in healthy individuals undergoing donor nephrectomy leads to better physical, psychological, and social outcomes. Surgical experience and the choice of extraction site can shorten the warm ischemia time significantly. Extraction through the inguinal region is recommended, as it provides for a faster removal and shortens the warm ischemia time. Laparoscopic donor nephrectomy can be used safely in centers with experience performing advanced laparoscopy.

show abstract

Section: Discussionmentioning

confidence: 99%

Extraction of Kidney via Suprapubic or Inguinal Incision in Total Laparoscopic Donor Nephrectomy

Sümer¹

2019

Laparosc Endosc Surg Sci

View full text Add to dashboard Cite

show abstract

“…Verbreitung gefunden haben neben den konventionell laparoskopischen und retroperitoneoskopischen insbesondere handassistierte Techniken. Single-Port-und NOTES-Techniken bleiben weiter eher einzelnen spezialisierten Zentren vorbehalten, während sich robotisch assistierte Lebendspenden zunehmender Beliebtheit erfreuen [8].…”

Section: Hintergrundunclassified

“…Neben der laparoskopischen Technik wurde auch ein rein retroperiteneoskopischer Ansatz beschrieben. Dieser bietet im Vergleich zum (robotisch assistierten) transabdominellen Vorgehen, bei ansonsten Vergleichbaren Ergebnissen, den Vorteil, keine Verletzung der intraabdominellen Organe zu riskieren [8,23,24].…”

Section: Vergleich Mit Konventionell Laparoskopischen Und Offenen Tecunclassified

Robotisch assistierte Nierenlebendspende – technische Aspekte und erste Evidenz

2021

View full text Add to dashboard Cite

ZusammenfassungDie minimalinvasive Nephrektomie zur Lebendspende hat sich über die letzten 2 Jahrzehnte zum Standard in den meisten Transplantationszentren entwickelt und hat zu einer Reduktion der postoperativen Morbidität beim Spender beigetragen. Die robotisch assistierte Technik stellt eine Alternative zur herkömmlichen (handassistierten) laparoskopischen Technik dar und wird in der Zukunft vermehrt Anwendung finden. In dieser Übersichtsarbeit gehen wir anhand unserer eigenen Erfahrungen auf technische Aspekte der robotischen Nephrektomie ein und geben einen Überblick über die aktuell verfügbare Literatur. Die robotisch assistierte Nierenlebendspende ist ein sicherer Eingriff mit einer sehr geringen postoperativen Komplikationsrate. Ein Vorteil des Eingriffs gegenüber der offenen Operationstechnik liegt in einer Reduktion des postoperativen Analgetikabedarfs und einer vergleichsweise reduzierten Krankenhausverweildauer bei jedoch verlängerter Operations- und Warmischämiezeit ohne messbaren Effekt auf die Transplantatfunktion. Die Ergebnisse entsprechen im Wesentlichen denen der laparoskopischen Technik, wobei sich eine weitere Beschleunigung der postoperativen Rekonvaleszenz andeutet. Die Vorteile der robotisch assistierten Technik liegen aufgrund der besseren Expositionsmöglichkeiten vornehmlich bei Patienten mit hohem BMI und multiplen Nierenarterien sowie bei rechtsseitigen Nephrektomien, bei denen eine längere Transplantatarterie gewonnen werden kann. Die robotisch assistierte Nierenlebendspende ist aus der Zukunft der Transplantationschirurgie nicht mehr wegzudenken und stellt eine ernst zu nehmende Alternative zur herkömmlichen laparoskopischen Technik dar.

show abstract

“…Irrespective of the type of incision, wound pain is a major source of anxiety for the donor. 33 Donor complications following laparoscopic live donor nephrectomy, of the 381 consecutive cases, 362 (95%) were left sided and 19 (5%) were right-sided laparoscopic donor nephrectomies. All 381 kidneys were procured and transplanted successfully with adequate renal artery and renal vein length to perform the recipient operation using standard techniques.…”

Section: Peri-operative Morbiditymentioning

confidence: 99%

Live kidney donor: surgical aspect and outcome

Deb¹,

Okechukwu²,

Emara³

et al. 2019

UNOAJ

View full text Add to dashboard Cite

There is evidence that delayed graft function and acute rejection, can adversely influence not only the short-term but also long-term graft survival. Obviously, the risk of delayed graft function is considerably lower in living-donor transplants than in cadaver transplants. Also, the incidence of acute rejection is lower, not only in living-related transplants with a good human leukocyte antigen (HLA) match but even in living-unrelated transplants. The aim of this review was to evaluate the surgical procedures applied in live kidney donor transplantation and their outcomes with regards to global best practices. We searched for studies that reported on living kidney transplantation and kidney donor, surgical aspect and Outcome, from inception till 2018, and we preferred articles that were published in English. The following electronic databases were used: PubMed, Science Direct, Medline, Embase, Google Scholar and Cochrane database. Living kidney donor transplantation is better than kidney transplantation from a deceased donor because the transplanted kidney becomes active and functional immediately after transplantation, whereas in transplants derived from deceased donors, the reverse is usually the case due to shorter ischemic time by minimal ischemic damage of the allograft. The surgical procedures applied in live kidney donor transplantation, are constantly undergoing modification inorder to minimize postoperative complications, improve treatment outcomes and enhance patient's quality of life.

show abstract

Minimally invasive donor nephrectomy: current state of the art

Cited by 24 publications

References 75 publications

Extraction of Kidney via Suprapubic or Inguinal Incision in Total Laparoscopic Donor Nephrectomy

Extraction of Kidney via Suprapubic or Inguinal Incision in Total Laparoscopic Donor Nephrectomy

Robotisch assistierte Nierenlebendspende – technische Aspekte und erste Evidenz

Live kidney donor: surgical aspect and outcome

Contact Info

Product

Resources

About