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Hand-assisted laparoscopic nephrectomy in living donors
L S Percegona1, F Meyer, C Machado
1Hospital Santa Casa de Misericórdia de Curitiba, Rua Visconde de Nacar, 865 sl 507 Curitiba, PR, 80.410-201 Brazil.
Transplantation Proceedings
|August 16, 2006
Summary
Hand-assisted laparoscopic nephrectomy (HLN) is a safe and effective minimally invasive option for living kidney donors. This procedure demonstrates low complication rates and yields high-quality grafts for recipients.
Area of Science:
- Surgical Innovation
- Minimally Invasive Surgery
- Nephrology
Background:
- Living donor nephrectomy is crucial for kidney transplantation.
- Minimally invasive techniques aim to reduce donor morbidity.
- Hand-assisted laparoscopic nephrectomy (HLN) combines laparoscopic and manual surgical approaches.
Purpose of the Study:
- To report the initial experience and outcomes of hand-assisted laparoscopic nephrectomy (HLN) in living kidney donors.
- To evaluate the safety and efficacy of HLN as an alternative to open nephrectomy.
Main Methods:
- Retrospective analysis of 58 consecutive hand-assisted laparoscopic nephrectomies performed on living kidney donors.
- Data collection included surgical time, ischemia time, blood loss, complications, and graft outcomes.
Main Results:
- Left kidney removed in 67%, right in 33%. Mean surgery time: 156.9 min; mean warm ischemia: 4.38 min; mean blood loss: 268 mL.
- Conversion to open surgery in 6.8% due to vascular lesions.
- High graft success rate (96.3% immediate diuresis), with low rates of complications like renal vein thrombosis (1.7%), lymphocele (5.1%), and urinary leakage (5.1%).
Conclusions:
- Hand-assisted laparoscopic nephrectomy (HLN) is a safe and effective alternative to open nephrectomy for living kidney donors.
- The procedure is associated with low postoperative morbidity and provides grafts of good morphological and functional quality for recipients.