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Mini incision live donor nephrectomy: an optimal approach for the developing countries.

A Kumar1, D M Tripathi, A Srivastava

  • 1Department of Urology and renal transplantation, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India. anant@sgpgi.ac.in

Clinical Transplantation
|February 6, 2004
PubMed
Summary

This study introduces a mini flank incision donor nephrectomy technique as a cost-effective alternative to laparoscopic donor nephrectomy. The mini incision approach offers a safe procedure with low morbidity, shorter hospital stays, and faster recovery for living kidney donors.

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Area of Science:

  • Nephrology
  • Surgical Innovation
  • Transplant Surgery

Background:

  • Laparoscopic donor nephrectomy (LD) is increasingly popular but expensive, posing a barrier in developing countries.
  • The high cost of LD limits donor affordability in many resource-limited settings.
  • Alternative, cost-effective donor nephrectomy techniques are needed.

Purpose of the Study:

  • To describe a mini flank incision (MD) donor nephrectomy technique.
  • To evaluate the outcomes of the mini flank incision donor nephrectomy.
  • To present a viable, affordable alternative to laparoscopic donor nephrectomy for living kidney donors.

Main Methods:

  • A 7-10 cm subcostal, rib-sparing transverse incision was utilized.
  • Dissections were performed using long retractors and instruments.

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  • Vessels were transfixed and cut, with clipping used in the final 45 cases.

    • Main Results:

    • 148 donor nephrectomies were performed between January 2000 and December 2002.
    • Mean operative time was 105 minutes, with a mean incision length of 9.1 cm.
    • Postoperative outcomes included a mean hospital stay of 2.2 days, 12% fever rate, 4% superficial wound infection, and a mean convalescence period of 22 days.

    Conclusions:

    • The extrapleural, extraperitoneal, subcostal mini incision donor nephrectomy is safe with low morbidity.
    • This technique results in shorter hospital stays, earlier convalescence, and improved cosmesis.
    • It is a cost-effective and ideal alternative for donor nephrectomy, particularly in developing countries.