Techniques of Laparoscopic Donor Nephrectomy in the United Kingdom: A narrative review

Laparoscopic living donor nephrectomy, first carried out in 1995 by Lloyd Ratner, is now the established gold standard technique of donor nephrectomy globally and in the United Kingdom. Its minimally invasive nature with associated patient benefits, and concomitant excellent recipient outcomes underpin surgeon preference as the technique of choice in living kidney donation. There are 23 transplant centres in the United Kingdom currently offering laparoscopic donor nephrectomy. There are however variations in the laparoscopic approach amongst and within the different centres. These variations have evolved due to various centre-related factors, including local expertise, training, and the availability of specific instrumentation. This review discusses the five variations of laparoscopic donor nephrectomy currently offered in the United Kingdom. These techniques include: Totally laparoscopic donor nephrectomy (TLDN), hand-assisted laparoscopic donor nephrectomy (HALDN), Robotic-assisted donor nephrectomy (RADN), Hand assisted retroperitoneoscopic (HARP) donor nephrectomy and Laparoscopic retroperitoneal donor nephrectomy (RDN).