Hand-assisted retroperitoneoscopic living donor nephrectomy superior to laparoscopic nephrectomy

Wadström, Jonas; Lindström, Pernilla; Engström, Birgitta

doi:10.1016/s0041-1345(03)00041-1

Cited by 22 publications

(17 citation statements)

References 6 publications

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“…The feasibility of this method has been demonstrated recently, but as to date there are limited data available advocating the use of one technique above the other [3-7]. This randomised controlled trial compares the hand-assisted retroperitoneal approach to the current standard, the transperitoneal laparoscopic technique to define the most optimal approach.…”

Section: Discussionmentioning

confidence: 99%

“…There is no randomized controlled trial comparing both techniques. Only three small studies compare left-sided hand-assisted retroperitoneoscopic with laparoscopic donor nephrectomy, but only with respect to clinical parameters [3-5,7]. Wadstrom et al compared the LDN (n = 11), hand-assisted laparoscopic technique (HALS) (n = 14), and the HARP (n = 18).…”

Section: Discussionmentioning

confidence: 99%

“…Wadstrom et al compared the LDN (n = 11), hand-assisted laparoscopic technique (HALS) (n = 14), and the HARP (n = 18). The operation time with the HARP was significantly shorter than the LDN (141 vs. 270 min, p < 0.01) [7]. Sundqvist et al performed a prospective study, comparing HARP (n= 11), LDN (n= 14) and open donor nephrectomy (n= 11).…”

Section: Discussionmentioning

confidence: 99%

“…The peritoneum remains intact and the risk of visceral injuries is reduced. The hand-assistance results in a faster procedure and a significantly reduced operating time [3-7]. The feasibility of this method has been demonstrated recently, but as to date studies advocating the use of one technique above the other are lacking.…”

Section: Introductionmentioning

confidence: 99%

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Hand-assisted retroperitoneoscopic versus standard laparoscopic donor nephrectomy: HARP-trial

et al. 2010

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BackgroundTransplantation is the only treatment offering long-term benefit to patients with chronic kidney failure. Live donor nephrectomy is performed on healthy individuals who do not receive direct therapeutic benefit of the procedure themselves. In order to guarantee the donor's safety, it is important to optimise the surgical approach. Recently we demonstrated the benefit of laparoscopic nephrectomy experienced by the donor. However, this method is characterised by higher in hospital costs, longer operating times and it requires a well-trained surgeon. The hand-assisted retroperitoneoscopic technique may be an alternative to a complete laparoscopic, transperitoneal approach. The peritoneum remains intact and the risk of visceral injuries is reduced. Hand-assistance results in a faster procedure and a significantly reduced operating time. The feasibility of this method has been demonstrated recently, but as to date there are no data available advocating the use of one technique above the other.Methods/designThe HARP-trial is a multi-centre randomised controlled, single-blind trial. The study compares the hand-assisted retroperitoneoscopic approach with standard laparoscopic donor nephrectomy. The objective is to determine the best approach for live donor nephrectomy to optimise donor's safety and comfort while reducing donation related costs.DiscussionThis study will contribute to the evidence on any benefits of hand-assisted retroperitoneoscopic versus standard laparoscopic donor nephrectomy.Trial RegistrationDutch Trial Register NTR1433

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Hand-assisted retroperitoneoscopic versus standard laparoscopic donor nephrectomy: HARP-trial

et al. 2010

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“…Additionally, some investigators have suggested that the results of hand‐assisted retroperitoneoscopic LDN is favorable to those of transperitoneal LLDN and OLDN. However, long‐term results of retroperitoneal LLDN have not been well quantitated and may not be appreciated until a greater length of follow‐up is available 17,18 …”

Section: Discussionmentioning

confidence: 99%

Hand‐assisted laparoscopic and open living donor nephrectomy in Korea

Yeo

Han

et al. 2005

Int J of Urology

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Results : There was one conversion to an open procedure due to bleeding in the LLDN group. The median operation times (180 min in LLDN versus 170 min in OLDN) and warm ischemic times (2.5 min in LLDN versus 2.0 min in OLDN) in the two groups were similar. The estimated mean blood loss, duration of hospital stay and complication rate was also similar in the two groups. The LLDN group reported less pain (visual analog scale) postoperatively (4.1 versus 5.3), but this was not significant ( P = 0.058). The time to oral intake in the LLDN group was significantly longer by an average of 1 day ( P = 0.001). Return to work was sooner in the LLDN group (4.0 weeks versus 6.0 weeks; P = 0.026). The recipient graft function was equivalent between the two groups. Handassisted LLDN appears to be a safe and effective alternative to OLDN. Conclusion : Our findings suggest that this technique may give the ability provide grafts of similar quality to OLDN, while extending to the donors the advantages of a traditional LLDN procedure.

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