Laparo-endoscopic single site (LESS) versus standard laparoscopic left donor nephrectomy: matched-pair comparison

Area of Science:

• Minimally Invasive Surgery
• Nephrology
• Transplant Surgery

Background:

• Laparo-endoscopic single site (LESS) surgery represents an advancement in minimally invasive surgical techniques.
• This study presents an initial comparative analysis of LESS donor nephrectomy (LESS-DN) versus standard laparoscopic living donor nephrectomy (LLDN).

Purpose of the Study:

• To evaluate if LESS-DN offers discernible advantages over LLDN during the perioperative phase and subsequent patient recovery.
• To compare patient-reported outcomes, including pain and convalescence timelines, between the two surgical approaches.

Main Methods:

• A retrospective matched-pair analysis was conducted on 18 patients who underwent LESS-DN (November 2007-November 2008).
• A control group of 17 patients who underwent standard LLDN was selected for comparison.
• Data collected included visual analog pain scores and patient-reported recovery endpoints.

Main Results:

• While mean warm ischemia time was longer in the LESS-DN group (6.1 vs 3 min), early allograft function was comparable.
• Patients in the LESS-DN group reported significantly faster convalescence, including fewer days on oral pain medication (6 vs 20), fewer days off work (18 vs 46), and faster return to full physical recovery (29 vs 83 days).
• Patient satisfaction and willingness to recommend the procedure were similar and favorable for both groups.

Conclusions:

• The single-port approach (LESS-DN) may be associated with a quicker convalescence compared to standard LLDN.
• Despite longer ischemia times, LESS-DN demonstrated comparable early allograft outcomes in this initial series.
• Patient-reported recovery metrics suggest potential benefits of LESS-DN for donor convalescence.