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Updated: Jun 21, 2026
Single Port Donor Nephrectomy
Published on: March 12, 2011
Laparoendoscopic single-site (LESS) nephrectomy through a Pfannenstiel incision: porcine model
Matthew L Steinway1, Irma J Lengu, Edward E Cherullo
1Center for Urologic Oncology and Minimally Invasive Therapies, University Hospitals Case Medical Center, Case Western Reserve University, Cleveland, Ohio 44106-5046, USA.
Purpose And Objective:
Laparoscopic nephrectomy has become a standard of care for localized renal tumors. Several groups have demonstrated single-incision laparoscopic nephrectomy performed completely through the extraction site, including transumbilical, paramedian, and transvaginal incisions. The Pfannenstiel incision is a commonly used extraction site after laparoscopic radical nephrectomy. The advantages of this incision include improved cosmesis as well as decreased pain. We investigated the feasibility of performing a single-incision laparoscopic nephrectomy through a Pfannenstiel incision in a porcine model, because this is the extraction site of choice at our institution.
Materials And Methods:
Bilateral laparoscopic nephrectomies were performed in five acute female swine through a GelPort inserted into a 4- to 6-cm incision comparable to the human Pfannenstiel incision.
Results:
Nine of 10 attempted nephrectomies were completed successfully. One nephrectomy was aborted because of a renal capsule laceration from a retraction injury. Mean operative time was 70.6 minutes (range 49-120 min). Mean estimated blood loss was 29.4 mL (range 5-100 mL).
Conclusions:
Laparoscopic nephrectomy through a single Pfannenstiel incision is technically feasible in the porcine model. We anticipate incorporating this approach in humans, because we commonly use the Pfannenstiel incision as an extraction site.