Background: Minimally invasive surgery has been applied to nearly all fi elds of surgery due to its advantages such as reduced morbidity, a better cosmetic outcome, and early recovery. The recent advances in its technique have allowed us to use modifi ed minimally invasive surgical technique in the fi eld of kidney transplantation. Materials and methods: From January 2004 to March 2006, minimally invasive video-assisted kidney transplantation (MIVAKT) was carried out in 20 patients. Many clinical variables were compared with the conventional method. The length of skin incision was equal to the diameter of grafted kidney, usually 7-8 cm. The incision was made between external iliac vessel and bladder marked pre-operatively with ultrasound. Laparoscopic balloon dissector was used to create the retroperitoneal space for the placement of the grafted kidney. The external iliac vessels were lifted as much as possible and surgical retractor was used. Sometimes intraluminal vascular anastomosis was needed and the kidney was suspended to both neighboring sites of the vascular anastomosis. Vascular anastomosis was performed under direct vision and with video-assisted TV monitoring for the assistant surgeon. Ureteroneocystostomy was carried out under direct vision. The grafted kidney was inserted into the previously made retroperitoneal space. Results: The total length of the MIVAKT incision was shorter than that for the CKT (7. 8 cm versus 21. 2 cm, P < 0. 001). The degree of pain was also lower in MIVAKT (5. 8 versus 7. 9, P < 0. 05). The operation time was 178 min, and this was longer than coventional technique by 18 min, but the difference was not statistically signifi cant (P=0. 78). There was no difference between the two methods as to the complications, graft function and episode of rejection. All patients were discharged at 2 weeks postoperatively. Conclusions: MIVKT is technically feasible and may offer benefi ts in terms of better cosmetic outcomes, less pain, and quicker recuperation than conventional kidney transplantation.
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