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Minimally Invasive Laparoscopic Donor Nephrectomy With a Pfannenstiel Incision Using Size-Reduced Trocars.

Jun Hagiuda1, Tsukasa Masuda1, Ryohei Takahashi1

  • 1Urology, Tokyo Dental College, Ichikawa General Hospital, Chiba, JPN.

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Summary

Minimally invasive laparoscopic donor nephrectomy (mLDN) using a Pfannenstiel incision offers high cosmetic results and comparable safety to standard procedures. This technique maintains kidney function and reduces analgesic use in donors.

Keywords:
cosmesislaparoscopic donor nephrectomyminimally invasive laparoscopypfannenstielsize-reduced trocar

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Nephrology

Background:

  • Laparoscopic donor nephrectomy (LDN) aims to reduce donor invasiveness.
  • Umbilical incisions in LDN present challenges in cosmesis and surgical difficulty.
  • A novel approach, minimally invasive LDN (mLDN) with a Pfannenstiel incision, was developed.

Purpose of the Study:

  • To assess the efficacy and safety of mLDN.
  • To evaluate cosmesis and operability of the mLDN technique.
  • To compare mLDN outcomes with conventional LDN.

Main Methods:

  • Retrospective analysis of 27 patients undergoing mLDN.
  • Utilized a 6 cm Pfannenstiel incision for kidney retrieval.
  • Employed three size-reduced trocars (2.5 mm and 5 mm).

Main Results:

  • Median operative time: 245 minutes; pneumoperitoneum time: 194 minutes.
  • Median warm ischemic time (WIT): 276 seconds.
  • No Clavien-Dindo grade ≥ 2 complications; improved recipient creatinine levels; unnoticeable scarring.

Conclusions:

  • mLDN is safe and offers high cosmesis with comparable operability to conventional LDN.
  • Kidney function is maintained despite longer WIT.
  • mLDN demonstrates reduced analgesic (NSAID) use and should be considered for LDN.