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Hand-assisted laparoscopic live donor nephrectomy using newly produced LAP DISC: initial three cases.
N Tokuda1, M Nakamura, M Tanaka
1Department of Urology, Faculty of Medicine, Kyushu University, Fukuoka, Japan. tokuda@uro.med.kyushu-u.ac.jp
Journal of Endourology
|September 13, 2001
Summary
The LAP DISC device shows promise for hand-assisted laparoscopic live donor nephrectomy (HALDN), facilitating kidney removal and potentially increasing donor nephrectomy adoption.
Area of Science:
- Urology
- Minimally Invasive Surgery
- Transplant Surgery
Background:
- A novel abdominal sealing device, the LAP DISC, was evaluated for its initial application in live donor nephrectomy.
- The device features a multi-ring, membrane-covered design adaptable for surgeon's hand insertion.
Purpose of the Study:
- To assess the feasibility and effectiveness of the LAP DISC in hand-assisted laparoscopic live donor nephrectomy (HALDN).
Main Methods:
- The LAP DISC was inserted via a 7-cm midline incision, followed by laparoscopic port placement and pneumoperitoneum establishment.
- Surgeons utilized their arm inserted through the LAP DISC for retraction, dissection, and hemostasis during nephrectomy.
- Kidney extraction was performed through the LAP DISC in all three donor nephrectomy cases.
Main Results:
- Operative times ranged from 195 to 323 minutes, with warm ischemic times of 4 to 15 minutes.
- Post-transplantation, allografts demonstrated immediate function, with recipient creatinine levels decreasing by postoperative day 1.
- Donors experienced rapid recovery, resuming oral intake within 24 hours and non-strenuous activity by postoperative day 6.
Conclusions:
- The LAP DISC device is highly effective for HALDN procedures.
- This device may encourage wider adoption of HALDN by both surgeons and potential donors.