Renal Hilus Ligation With Single Stapler in Laparoscopic Donor Nephrectomy

Area of Science:

• Urology
• Surgical Innovation
• Transplant Surgery

Background:

• Laparoscopic donor nephrectomy is the standard for living donor kidney transplantation.
• Renal pedicle control, typically using laparoscopic staplers, is a critical surgical step.
• The cost and complexity of using multiple staplers for pedicle ligation are significant.

Purpose of the Study:

• To evaluate the safety and efficacy of using a single vascular stapler for renal artery and vein ligation during laparoscopic donor nephrectomy.
• To assess the feasibility of single stapler use in cases with single or multiple renal vessels.

Main Methods:

• Retrospective analysis of 120 laparoscopic donor nephrectomy cases performed between December 2017 and August 2018.
• Data collected included demographic information, vessel anatomy, ligation technique, operative time, and complication rates.
• All procedures were performed laparoscopically by two experienced surgeons.

Main Results:

• A single stapler was successfully used for renal pedicle ligation in 115 out of 120 cases (95.8%).
• The majority of cases (91.7%) had a single renal artery, but single stapler use was also effective in cases with multiple arteries (up to 3).
• No major complications were reported for the donors, and no graft implantation issues occurred.

Conclusions:

• Single stapler application for renal hilus ligation is a safe and secure method in laparoscopic donor nephrectomy.
• This technique is effective even in kidneys with multiple renal arteries and veins, potentially reducing costs and procedure complexity.
• The study supports the adoption of single stapler use as a reliable standard practice.