Retroperitoneoscopic Living Donor Nephrectomy: A Retrospective Comparison to the Open Approach

Abstract

A purely retroperitoneoscopic approach in living kidney donation is used by only a few centers worldwide. Data from 28 consecutive purely retroperitoneoscopic living donor nephrectomies (RLDN) were compared to the most recent 30 open living donor nephrectomies (OLDN). Right-sided donation was performed in 12 cases (43%) of the RLDN and 11 cases (37%) of the OLDN. Comparison of the results between the two groups showed a shorter operation time and hospital stay for the RLDN group (P < 0.001). Warm ischemia time was significantly shorter in the OLDN group (P < 0.02). The rate of complications did not differ significantly between the groups. No significant difference in terms of renal graft function was detected within 30 days after surgery. As a result of the direct access, RLDN is superior in terms of operation time, even to the open access on our series, while maintaining the advantage of minimal invasiveness.

Complications of retroperitoneoscopic living donor nephrectomy: single center experience after 164 cases

“…One of the largest series in the literature is from the University of Maryland, which reported a 6.8% intraoperative and 17.1% postoperative complication rate with 738 laparoscopic donor nephrectomies [24]. The rate of major complications in our series (5.5%) was in the range of published data for open (1-6%) or laparoscopic techniques (1-6.3%) [3,4,28].…”

“…Furthermore, the decision was based on the policy of selecting the kidney with the lowest risk of technical failure, but most importantly, leaving the donor with the "better" kidney [13,14]. Our retroperitoneoscopic technique was described recently in publication [3,15].…”

“…In 2000, Gill et al [2] reported for the Wrst time of a retroperitoneoscopic approach to donor nephrectomy and autotransplantation where successful allograft outcome was achieved without vascular complications. Extensive data have been published showing that conventional laparoscopic and retroperitoneoscopic techniques for donor nephrectomy have a similar complication rate [3][4][5]. Retroperitoneoscopy provides two major advantages: Wrst, it oVers a quick access to the blood vessels comparable to the open approach and second, it has no interference with bowel, liver, or abdominal adhesions.…”

Comparing Surgical Complications of Donors and Recipients in Retroperitoneoscopic versus Mini-Incision Donor Nephrectomy: A Single-Center Experience

“…Table 3 provides information about the type of complications in both groups. Donors were discharged 6.5 [3][4][5][6][7][8][9][10][11][12] days after MIDN and 4.9 [3][4][5][6][7][8][9][10][11][12][13] days after RPDN, which was significantly different ( < 0.001, Table 1). None of the donors was forced to leave hospital before his or her subjective well-being.…”

“…The retroperitoneoscopic technique described by Bachmann et al [9][10][11] was applied with some modifications; briefly three 12 mm trocars were placed in a typical right-or left-sided overextended flank position. Starting with the herloon hernia balloon (Braun, Melsungen, Germany), a retroperitoneal space from an incision 1 cm below the 12th rib and above the horizontal lateral line of the translucent erector trunci muscle was fashioned.…”