Retroperitoneal Laparoscopic Living&amp;ndash;Donor Nephrectomy

Hoznek, Andràs; Olsson, Leif Eric; Salomon, Laurent; Saint, F.; Cicco, Antony; Chopin, Dominique; Abbou, Clément-Claude

doi:10.1159/000049846

Cited by 39 publications

(16 citation statements)

References 21 publications

(26 reference statements)

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“…Camera placement is not difficult as already mentioned in other reports (21)(22)(23), but control of the fiberscope is not easy because its movement is limited. Since we did not have a robotic machine to hold the fiberscope, an assistant had to hold the camera during the entire procedure.…”

Section: Discussionmentioning

confidence: 92%

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Retroperitoneoscopic Live Donor Nephrectomy (RPLDN): Establishment and Initial Experience of RPLDN at a Single Center

Tanabe

Miyamoto

Ishida

et al. 2005

American Journal of Transplantation

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We tried to establish the technique of retroperitoneoscopic live donor nephrectomy (RPLDN).Between July 2001 and March 2004, 135 renal transplant donors underwent RPLDN. Low (average: 7 mmHg) CO 2 gas pressure was employed during the procedure. All procedures were performed through a three-port retroperitoneal approach without opening the peritoneal cavity. The hand-assisted technique was not used. One hundred and twenty-seven cases were of left and eight cases were of right nephrectomy. Donor nephrectomy was carried out successfully in all patients. In one donor, the procedure was changed to open donor nephrectomy because of severe adhesion around the renal vein due to previous surgery. No serious complications, such as massive bleeding or bowel injury were encountered. Return of bowel function took 0.7 days on average. Post-operative hospital stay was 4.9 days on average, and return to work was 12 days on average. Ureteral complications occurred in 2 patients and were treated with temporally retrograde ureteral stenting. Average serum creatinine levels were 1.5 mg/dL, 1.3 mg/dL and 1.3 mg/dL at 3, 7 and 14 days after transplantation, respectively. No patients required hemodialysis after transplantation due to acute tubular necrosis. RPLDN could be an option for laparoscopic live donor nephrectomy.

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Section: Discussionmentioning

confidence: 92%

“…However, no systematic analysis of RPLDN has been reported except for a few case reports (21)(22)(23). Therefore, we tried to establish the technique of RPLDN as a potential option for laparoscopic live donor nephrectomy.…”

Section: Introductionmentioning

confidence: 99%

Retroperitoneoscopic Live Donor Nephrectomy (RPLDN): Establishment and Initial Experience of RPLDN at a Single Center

Tanabe

Miyamoto

Ishida

et al. 2005

American Journal of Transplantation

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“…Therefore some authors favour the retroperitoneal access, performed with a flank incision and blunt dissection of the retroperitoneal space with the surgeon's finger and followed by insufflation and insertion of the trocars. So far only a few studies investigating the retroperitoneal access for LDN in three to ten donors have been published (15)(16)(17). The authors using this approach recommend it for surgeons who are well acquainted with retroperitoneal open donor nephrectomy, so that the learning curve for LDN may be abbreviated (15,18).…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic donor nephrectomy

Değer

Giessing

Roigas

et al. 2005

Minimally Invasive Therapy & Allied Technologies

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Laparoscopic live donor nephrectomy (LDN) has removed disincentives of potential donors and may bear the potential to increase kidney donation. Multiple modifications have been made to abbreviate the learning curve while at the same time guarantee the highest possible level of medical quality for donor and recipient. We reviewed the literature for the evolution of the different LDN techniques and their impact on donor, graft and operating surgeon, including the subtleties of different surgical accesses, vessel handling and organ extraction. We performed a literature search (PubMed, DIMDI, medline) to evaluate the development of the LDN techniques from 1995 to 2003. Today more than 200 centres worldwide perform LDN. Hand-assistance has led to a spread of LDN. Studies comparing open and hand-assisted LDN show a reduction of operating and warm ischaemia times for the hand-assisted LDN. Different surgical access sites (trans- or retroperitoneal), different vessel dissection approaches, donor organ delivery techniques, delivery sites and variations of hand-assistance techniques reflect the evolution of LDN. Proper techniques and their combination for the consecutive surgical steps minimize both warm ischaemia time and operating time while offering the donor a safe minimally invasive laparoscopic procedure. LDN has breathed new life into the moribund field of living kidney donation. Within a few years LDN could become the standard approach in living kidney donation. Surgeons working in this field must be trained thoroughly and well acquainted with the subtleties of the different LDN techniques and their respective advantages and disadvantages.

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“…No long-term studies exist and it is unclear if the pneumoretroperitoneum will alter the ultimate function of the allograft. In the largest series (three patients), one patient suffered ureteral complications, which mirrored our early experience with transperitoneal donor nephrectomy [44]. No data are available on lengths of renal vein or ureter from the retroperitoneal approach.…”

Section: Laparoscopic Donor Nephrectomymentioning

confidence: 88%

Taking the side of transperitoneal access for surgery in upper urinary tract

2004

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Laparoscopic surgery has become a preferred treatment option for the management of upper urinary tract pathology. Large series of complex urologic operations have been published, with favorable outcomes. Although the early experience with urologic laparoscopy consisted almost exclusively of transperitoneal procedures, some surgeons prefer the retroperitoneal approach. The debate of retroperitoneal versus transperitoneal laparoscopy for upper tract pathology is complex because comparative and randomized studies are lacking. In contrast to the retroperitoneal approach, transperitoneal laparoscopic procedures allow for a larger working space, adequate maneuverability, and the presence of familiar anatomic landmarks. This article highlights our experiences and approaches to major laparoscopic upper urinary tract surgery for benign and malignant conditions. A summary of the published literature as it pertains to the transperitoneal approach also is presented.

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Retroperitoneal Laparoscopic Living–Donor Nephrectomy

Cited by 39 publications

References 21 publications

Retroperitoneoscopic Live Donor Nephrectomy (RPLDN): Establishment and Initial Experience of RPLDN at a Single Center

Retroperitoneoscopic Live Donor Nephrectomy (RPLDN): Establishment and Initial Experience of RPLDN at a Single Center

Laparoscopic donor nephrectomy

Taking the side of transperitoneal access for surgery in upper urinary tract

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