Surgical complications of laparoendoscopic single-site donor nephrectomy: a retrospective study

Abstract

The single-port approach has been associated with an unacceptably high rate of umbilical port hernias in large series of patients undergoing single-port cholecystectomy and colectomy and with additional surgical risks thought secondary to technical and ergonomic limitations. A retrospective review of 378 consecutive laparoendoscopic single-site(LESS) donor nephrectomies performed between 04/15/2009 and 04/09/2014 was conducted. Twelve patients (3%) developed an umbilical hernia. Eleven (92%) were female and eight (73%) of these patients had a prior pregnancy. Hernias were reported 13.5 ± 6.9 months after donation, and the mean size was 5.1 ± 3.7 cm. Seven additional cases (1.9%) required a return to the operating room for internal hernia (2), evisceration (1), bleeding (1), enterotomy (1), and wound infection (2). The original incision was utilized for reexploration. One patient required emergent conversion to an open procedure for bleeding during the initial donation. There were no mortalities. Recipient patient and graft survival were 99% and 99% at 1 year, respectively. Although reports associated with earlier experiences with single-site procedures suggested an unacceptably high rate of hernias at the surgical site, this does not seem to be the case at our center. This technique is a reliable surgical technique for left donor nephrectomy at this institution.

Evolution of Laparoscopic Donor Nephrectomy Techniques and Outcomes: A Single-Center Experience with More than 1000 Cases

“…In early cases of LESSOP-DN, the incision was made in middle of the umbilicus, but in later cases the incisions were modified to periumbilical incisions, which prevented hernias afterwards. When comparing our results to those of other studies, La Mattina et al reported that the most common complication in LESS-DN was an umbilical hernia, which resulted in 1.9% postoperative hernia operations [32]. Serrano et al reported a 4% rate of incisional hernia in HALDN [33].…”

Mesocolic hernia following retroperitoneal laparoscopic radical nephrectomy: A case report

“…We sometimes experience adhesional hernias after abdominal surgery, however, an internal hernia after RLN is rare. We searched PubMed for reports of an internal hernia after RLN, and only 17 cases have been reported in literature including our case (Table 1) [1,2,5,[10], [11], [12], [13], [14], [15], [16], [17], [18], [19]]. Radical nephrectomy for cancer and donor nephrectomy comprised of seven cases each.…”

Long-Term Consequences of Nonclosure of Mesenteric Defects after Traditional Right Colectomy

“…Nonclosure of the mesenteric defect may cause internal herniation, which in turn can cause intestinal obstruction [ 5 – 9 ]. However, the occurrence of such obstruction has not been well documented, and closure of mesenteric defects remains in debate [ 10 – 12 ]. In the past, there were case reports on the issues regarding repair of the mesenteric defect of right colectomy as the standard procedure [ 13 – 15 ].…”