Two- and three-dimensional laparoscopic donor nephrectomy: a comparative study of a single-center experience

This is the first report on three-dimensional (3D) laparoscopic donor nephrectomy performed in the Central Asian region and Commonwealth of Independent States countries. This study presents the results of our initial experiences of 3D hand-assisted laparoscopic donor nephrectomy (3D-HALDN) in comparison with the outcomes of two-dimensional hand-assisted laparoscopic donor nephrectomy (2D-HALDN) at a single center.

From 2015 to 2019, 19 3D-HALDN and 19 2D-HALDN procedures were performed at the same center by two surgeons. All 38 procedures used identical techniques. Between-group differences were considered statistically significant at P<0.05.

The baseline characteristics in both groups were statistically comparable (P>0.05). All donors underwent left nephrectomy. Donors who underwent 3D-HALDN had better outcomes than those who underwent 2D-HALDN, as shown by a shorter warm ischemic time (P<0.05), a shorter operative time (P<0.05), and less blood loss (P<0.05). There were no conversions or major complications (according to the Clavien-Dindo classification) in either group. The average drainage duration and postoperative hospitalization were significantly shorter in the 3D-HALDN group (P<0.05). The between-group differences in the mean postoperative creatinine level and glomerular filtration rate were not significant.

The 3D-HALDN approach is more beneficial than traditional 2D-HALDN by providing a shorter warm ischemic time, less blood loss, and shorter durations of drainage and postoperative hospitalization. Postoperative complications and the functional condition of the kidney in donors in the early and late postoperative periods did not depend on the type of laparoscopic donor nephrectomy.