Enhancing donor outcomes: simultaneous laparoscopic living donor nephrectomy and concomitant surgical procedures

Laparoscopic living donor nephrectomy (LLDN) has become the gold standard for renal transplantation. However, performing LLDN concurrently with other surgical procedures remains scarcely reported. This study evaluates the safety and feasibility of simultaneous LLDN with additional laparoscopic surgeries.

A prospective analysis was conducted on 294 cases from November 2018 to May 2023 at our transplant center. Among these, 15 donors underwent concomitant laparoscopic procedures alongside LLDN. Pre-operative evaluations included comprehensive medical histories, laboratory tests, and dual-CT angiography. The surgical outcomes, including operative time and intra- and post-operative complications, were meticulously recorded.

The median age of donors was 57 years, with a median BMI of 27 kg/m². The majority (66%) were female. Simultaneous procedures included laparoscopic cholecystectomy (10 cases), hernia repair (3 cases), a hepatic cyst unroofing (1 case), and an ovarian cyst excision (1 case). The mean operative time for LLDN was 140 min, with a total mean operative time of 164.33 min for combined surgeries. No intra-operative complications were observed. The mean hospital stay was 3 days, with early mobilization and no significant post-operative complications reported.

Simultaneous LLDN and additional laparoscopic procedures are safe and feasible when performed by an experienced surgical team. This approach can improve donor outcomes by avoiding the need for multiple surgeries and additional anesthesia, thereby enhancing recovery and quality of life.