Single Stapler Technique for Vascular Control in Laparoscopic Donor Nephrectomy

Sozener, Ulas

doi:10.1016/j.transproceed.2020.08.018

Cited by 1 publication

(1 citation statement)

References 14 publications

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“…Multiple maneuvers and surgical approaches for ligation of vessels have been developed to best handle the right renal hilum, including those for the right renal vein (RRV), [5][6][7][8] the right renal artery (RRA) 9,10 , and both renal vessels. 11 We describe a midline rotating maneuver of the right donor kidney that provides better visualization and easier dissection of the renal hilum, making stapling of the renal vessels easier to perform and maximizing the RRA and RRV lengths. Clinical outcomes among the transplant recipients who received these right living donor kidneys (with multiple arteries and vein reconstruction) are also included in this report.…”

Section: Introductionmentioning

confidence: 99%

Midline Rotation of the Right Renal Hilum During Hand-Assisted Laparoscopic Living Donor Nephrectomy

Ciancio

Farag

Gaynor

et al. 2021

JSLS

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Background/Objectives: Laparoscopic living donor nephrectomy (LLDN) of the right kidney is currently considered as part of standard of care; however, dealing with the renal hilum when performing ligation/division of its renal vessels is still a main concern. Here, we describe a simpleto-perform technique, i.e., flipping the fully mobilized right kidney to the midline so that the renal artery becomes anteriorly, which offers better visualization and easier dissection of the renal vessels (achieving maximized lengths) when performing hand-assisted LLDN of the right kidney.Methods: Living donors who underwent hand-assisted LLDN of the right kidney, along with their respective renal transplant recipients, were included in this report. Donor characteristics included renal artery and vein lengths; recipient characteristics included creatinine at months 12 -36. Graft vein and arterial anastomosis data were also reported.Results: Nineteen living donors and 19 recipients, with median donor and recipient ages being 39 (24 -60) and 53 (3 -81) years, respectively, were included. None of the 38 patients had intra-or postoperative complications. Donor renal vein was anastomosed to the right external iliac vein (n = 16), right common iliac vein (n = 2), and inferior vena cava (n = 1). Gonadal vein (n = 1) and deceased donor iliac vein (n = 2) were used to increase the right renal vein length in 3 cases. Four donor kidneys had 2 arteries reconstructed side by side. None of the recipients developed any vascular or urological complications. Conclusions:The laparoscopic technique described is safe and allows better visualization of the right hilum, mainly the renal artery, and helps in stapling the renal vein and renal artery.

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