Laparoendoscopic single-site donor nephrectomy (LESS-DN) versus standard laparoscopic donor nephrectomy

Area of Science:

• Minimally invasive surgical techniques
• Nephrology and Urology
• Transplant surgery

Background:

• Laparoscopic donor nephrectomy is the standard for kidney donation, offering benefits over open surgery.
• Laparoendoscopic single-site donor nephrectomy (LESS-DN) utilizes a single incision, potentially offering further advantages.
• Previous studies suggest LESS-DN may increase donor rates and improve donor outcomes.

Purpose of the Study:

• To review the benefits and harms of LESS-DN compared to standard laparoscopic nephrectomy.
• To evaluate LESS-DN as a minimally invasive option for live kidney donors.

Main Methods:

• Systematic review of randomized controlled trials (RCTs).
• Searched Cochrane Kidney and Transplant's Specialised Register.
• Included three RCTs comparing LESS-DN with standard laparoscopic donor nephrectomy in adults.

Main Results:

• No significant differences in operative time, blood loss, or complication rates between LESS-DN and standard laparoscopic nephrectomy.
• Significantly lower pain scores at discharge observed in the LESS-DN group.
• No significant differences in hospital stay, return to normal activities, or graft loss.

Conclusions:

• Current evidence is insufficient to definitively state LESS-DN is superior to standard laparoscopic donor nephrectomy.
• Further well-designed, adequately powered RCTs are required to establish the role of LESS-DN.
• LESS-DN may offer reduced post-operative pain for kidney donors.