Laparoscopic Live Donor Nephrectomy: A Technical Road Map

Levey, Helen R.; Rais‐Bahrami, Soroush; Richstone, Lee; Kavoussi, Louis R.

doi:10.1089/end.2010.0529

Cited by 9 publications

(9 citation statements)

References 43 publications

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“…A transperitoneal laparoscopic approach was performed for kidney transplant procurement. 17 Donors’ characteristics (age, gender, tobacco smoking, body mass index) were recorded.…”

Section: Methodsmentioning

confidence: 99%

External Validation of a Predictive Model to Estimate Renal Function After Living Donor Nephrectomy

et al. 2021

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“…A transperitoneal laparoscopic approach was performed for kidney transplant procurement. 17 Donors’ characteristics (age, gender, tobacco smoking, body mass index) were recorded.…”

Section: Methodsmentioning

confidence: 99%

External Validation of a Predictive Model to Estimate Renal Function After Living Donor Nephrectomy

et al. 2021

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“…The technique of conventional LDN has been previously described and recently updated . The extraction site was prepared through a Pfannenstiel incision before transection of the renal vessels.…”

Section: Methodsmentioning

confidence: 99%

Comparison of laparoendoscopic single site (LESS) and conventional laparoscopic donor nephrectomy at a single institution

et al. 2013

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• Most transplant centres harvest living donor kidneys via a conventional laparoscopic surgical approach.Laparoendoscopic single-site donor nephrectomy (LESS-DN) is a relatively novel minimally invasive approach that allows the surgery to be performed via a single incision. This technique may be advantageous in decreasing surgical morbidity and improving cosmetic outcomes, thus plausibly reducing the barriers to kidney donation.• The study demonstrates the safety and feasibility of LESS-DN in a large consecutive series of kidney donors.Comparative analysis between LDN and LESS-DN showed that there was a significant decrease in intra-operative blood loss and allograft warm ischaemia time in the LESS-DN group, but also a significant increase in operating time. Other peri-operative outcomes were similar between the two approaches. Evaluation of the LESS-DN cases alone revealed that, the operating times did not significantly change through the course of the series. Using this outcome as a surrogate for technical difficulty suggests a relatively shallow learning curve for LESS-DN. Objective• To present a comparative analysis of peri-operative outcomes for >200 cases of conventional laparoscopic donor nephrectomy (LDN) and laparoendoscopic single site donor nephrectomy (LESS-DN). Patients and Methods• From 2006 to 2011, 213 donor nephrectomies were performed by two surgeons (R.E.L and W.A.M.) at a tertiary transplant centre. The approach changed from conventional LDN to LESS-DN over the course of the series.• The two approaches were compared retrospectively and evaluated for differences in peri-operative outcomes.• Statistical significance was assessed using Student's t-test and chi-squared analysis. Results• A total of 111 patients underwent LDN and 102 patients underwent LESS-DN. • Total operating time was significantly longer in the LESS-DN group (206.1 vs 181.9 min, P < 0.001), but LESS-DN resulted in less intra-operative blood loss (61.5 mL vs 85.9 mL, P < 0.001) and shorter warm ischaemia times (4.4 vs 5.0 min, P = 0.01).• There were no significant differences in analgesic requirements, subjective pain scores, length of hospital stay, postoperative graft function, or donor's postoperative glomerular filtration rate between the two approaches.• Complication rates were low regardless of the approach, and there were no major complications (>grade II) in the LESS-DN group. Conclusions• In experienced hands, LESS-DN results in peri-operative outcomes similar to those of conventional LDN without compromising donor safety, while providing a desirable cosmetic result.• For surgeons familiar with LDN, transitioning to the LESS approach using this technique appears to have a relatively short learning curve.

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“…Kavoussi and Ratner in 1995. 5 Hand assisted laparoscopic donor nephrectomy (HALDN) was introduced by Wolf et al, in 1998 due to concerns pertaining to the donor and prolonged warm ischaemia time (WIT) using the totally laparoscopic technique. 6e9 Of the minimally invasive techniques, HALDN/hand assisted retroperitoneal donor nephrectomy (HARPDN) offers tactile and haptic feedback with the added ability and advantage to digitally retract tissues.…”

Section: Living Donor Kidney Transplantationmentioning

confidence: 99%

Laterality in laparoscopic hand assisted donor nephrectomy - Does it matter anymore? Outcomes of a large retrospective series

Vaz¹,

Asderakis²,

Sharma³

et al. 2022

The Surgeon

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Laparoscopic Live Donor Nephrectomy: A Technical Road Map

Cited by 9 publications

References 43 publications

External Validation of a Predictive Model to Estimate Renal Function After Living Donor Nephrectomy

External Validation of a Predictive Model to Estimate Renal Function After Living Donor Nephrectomy

Comparison of laparoendoscopic single site (LESS) and conventional laparoscopic donor nephrectomy at a single institution

Laterality in laparoscopic hand assisted donor nephrectomy - Does it matter anymore? Outcomes of a large retrospective series

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