A comparison of kidney retrieval incisions in laparoscopic transperitoneal donor nephrectomy

To compare the modified iliac fossa and Pfannenstiel incisions for retrieving the kidney in laparoscopic transperitoneal donor nephrectomy.

Two different incisions for retrieving the donor kidney were studied from January 2002 to December 2006. A total of 343 laparoscopic transperitoneal donor nephrectomies were performed. 110 kidneys were removed via our modified iliac fossa incision and 233 kidneys were retrieved using a Pfannenstiel incision. The warm ischemia time, analgesic requirement and hospital stay were compared. Other parameters studied were the length of incisions, total number of incisions (port and retrieval), and complications associated with them.

The warm ischemia time (3 vs. 3.5 min), mean hospital stay (3.35 vs. 3.8 days) and analgesic requirement were comparable. The mean length of incisions was 5.8 vs. 7.3 cm, respectively, and this difference was found to be statistically significant. The total number of incisions (port and retrieval) was 4 when the iliac fossa incision was used, whereas it was 5 when the kidney was retrieved using a Pfannenstiel incision. Two patients had bladder injury and 1 patient had bowel injury while making the Pfannenstiel incision. There was less morbidity associated with the iliac fossa incision.

The iliac fossa incision had less morbidity whereas the Pfannenstiel incision scored in terms of cosmesis.