Solo-surgeon pure laparoscopic donor nephrectomy using passive camera holder: IDEAL stage 2a study

Area of Science:

• Urology
• Minimally Invasive Surgery
• Transplantation Surgery

Background:

• Solo-surgery involves a surgeon operating alone with a camera holder, excluding other surgical team members except a scrub nurse.
• This study investigates the feasibility and safety of solo-surgeon pure laparoscopic donor nephrectomy.

Purpose of the Study:

• To evaluate the technical feasibility of performing donor nephrectomy using a solo-surgeon approach with a passive camera holder.
• To assess the safety profile, including perioperative complications, of this minimally invasive surgical technique.

Main Methods:

• A prospective clinical trial was conducted with Institutional Review Board approval.
• Forty patients underwent solo-surgeon pure laparoscopic donor nephrectomy, with feasibility assessed by successful completion without conversion.
• Perioperative complications were meticulously recorded and analyzed to determine safety.

Main Results:

• Solo-surgeon pure laparoscopic donor nephrectomy demonstrated 100% feasibility, with no cases requiring conversion to human-assisted surgery.
• Fourteen intraoperative complications occurred in 10 patients, most commonly spleen injury.
• Thirty-four patients experienced 78 postoperative complications, predominantly nausea/vomiting and liver enzyme elevation, largely independent of solo-surgery.

Conclusions:

• Solo-surgeon pure laparoscopic donor nephrectomy utilizing a passive camera holder is technically achievable.
• Adjusting the scope of procedures performed solo is crucial for optimizing safety.
• The technique shows promise but requires careful patient selection and procedural planning.