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The effect of pneumoperitoneum on kidney function in laparoscopic donor nephrectomy
Abdelkader Hawasli1, Henry Oh, Edward Schervish
1Department of Surgery, St. John Hospital and Medical Center, Detroit, Michigan, USA.
The American Surgeon
|April 29, 2003
Summary
Laparoscopic donor nephrectomy using 10 or 15 mm Hg pneumoperitoneum pressure showed no significant difference in kidney function for donors or recipients. Both pressure settings resulted in comparable intraoperative and postoperative outcomes.
Area of Science:
- Nephrology
- Transplantation Surgery
- Minimally Invasive Surgery
Background:
- Laparoscopic donor nephrectomy is a standard procedure for kidney transplantation.
- Pneumoperitoneum pressure during surgery may impact kidney function.
- Optimal pneumoperitoneum settings require further investigation to ensure donor and recipient safety.
Purpose of the Study:
- To compare the effects of two different pneumoperitoneum pressure settings (10 mm Hg vs. 15 mm Hg) during laparoscopic donor nephrectomy on kidney function.
- To evaluate the impact of these pressure settings on both the donor's remaining kidney and the procured kidney in the recipient.
Main Methods:
- A prospective study was conducted between June 1999 and November 2001.
- Donors were divided into two groups based on pneumoperitoneum pressure settings (10 mm Hg or 15 mm Hg).
- Kidney function was assessed by comparing preoperative and postoperative serum creatinine levels, operative time, intraoperative fluid, and urine output in both donors and recipients.
Main Results:
- No statistically significant differences were observed between the two groups regarding donor or recipient age, gender, or body mass index.
- Operative time, intraoperative fluid administration, and urine output in donors did not differ significantly between the 10 mm Hg and 15 mm Hg groups.
- Preoperative and postoperative serum creatinine levels in donors showed no significant difference between groups. Recipients' serum creatinine levels differed over time but not between the pressure groups.
Conclusions:
- Procurement of kidneys using either 10 mm Hg or 15 mm Hg abdominal pressure during laparoscopic donor nephrectomy yields equally effective intraoperative and postoperative results.
- Both tested pneumoperitoneum pressure settings are safe and do not compromise kidney function in donors or recipients.
- This study supports the use of either 10 or 15 mm Hg pneumoperitoneum in laparoscopic donor nephrectomy without compromising outcomes.