First prize: Standard laparoscopic donor nephrectomy versus laparoendoscopic single-site donor nephrectomy: a...

Area of Science:

• Urology
• Minimally Invasive Surgery
• Transplant Surgery

Background:

• Donor nephrectomy is crucial for kidney transplantation.
• Standard laparoscopic donor nephrectomy is a common procedure.
• Laparoendoscopic single-site (LESS) donor nephrectomy is an emerging alternative.

Purpose of the Study:

• To compare clinical outcomes between standard laparoscopic and LESS donor nephrectomies.
• To evaluate postoperative pain, quality of life, and cosmetic satisfaction.
• To assess graft function and complications in recipients.

Main Methods:

• A randomized trial involving 50 voluntary renal donors.
• Donors were assigned to either standard laparoscopic or LESS donor nephrectomy.
• Primary endpoint was postoperative pain; secondary endpoints included quality of life, body image, cosmetic scores, and graft function.

Main Results:

• Operating times were similar between groups.
• Surgeon difficulty was higher in the LESS group.
• Postoperative pain scores improved earlier in the LESS group, with similar analgesic requirements.
• Warm ischemia time was longer in the LESS group, but total ischemia time was comparable.
• Complication rates and graft function at one year were similar.
• Hospital stay was shorter for patients undergoing LESS donor nephrectomy.

Conclusions:

• LESS donor nephrectomy provides early pain relief and shorter hospital stays.
• Despite increased surgical difficulty and longer warm ischemia times, LESS donor nephrectomy is a viable option.
• Comparable graft function and donor quality of life support the use of LESS donor nephrectomy in select cases.