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Comparison of Incision Types Used for Kidney Extraction in Laparoscopic Donor Nephrectomy: A Retrospective Study.

Selçuk Şahin1, Osman Özdemir2, Mithat Ekşi3

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Both iliac fossa and Pfannenstiel incisions are safe for laparoscopic donor nephrectomy (LDN). While Pfannenstiel incisions show longer operation and warm ischemia times, they do not increase complications or analgesic needs compared to iliac fossa incisions.

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Area of Science:

  • Urology
  • Transplant Surgery
  • Minimally Invasive Surgery

Background:

  • Laparoscopic donor nephrectomy (LDN) is standard for kidney transplantation.
  • Various extraction incisions exist, including iliac fossa and Pfannenstiel approaches.
  • Comparing these incision types is crucial for optimizing LDN outcomes.

Purpose of the Study:

  • To compare the efficacy and safety of iliac fossa versus Pfannenstiel incisions for kidney extraction during LDN.
  • To evaluate differences in operative parameters and patient outcomes between the two incision techniques.

Main Methods:

  • Retrospective analysis of 203 LDN cases (June 2016 - February 2020).
  • Exclusion of patients with specific comorbidities or conversion to open surgery.
  • Comparison of demographic data, operative times, warm ischemia times, and postoperative outcomes between iliac fossa and Pfannenstiel groups.

Main Results:

  • No significant demographic differences between the 65% (iliac fossa) and 35% (Pfannenstiel) groups.
  • Significantly longer operation time (p=0.001) and warm ischemia time (p=0.016) in the Pfannenstiel group.
  • No significant differences in blood loss, hospital stay, analgesic use, or postoperative complications.

Conclusions:

  • Both iliac fossa and Pfannenstiel incisions are viable for kidney extraction in LDN.
  • Pfannenstiel incisions are associated with longer operative and warm ischemia times but similar safety profiles.
  • Choice of incision can be based on surgeon preference and patient factors without compromising safety.