Hand-assisted laparoscopic donor nephrectomy. Ascending the learning curve.
BACKGROUND
The hand-assisted approach to laparoscopic donor nephrectomy (LDN) might minimize the learning curve and shorten both the operation and the warm ischemia time. Our initial results from hand-assisted LDN are presented and compared with data from the literature.


METHODS
From January to September 2000, ten hand-assisted LDNs of the right kidney were performed.


RESULTS
The median operation time was 140 min (range, 120-400 min), and the warm ischemia time was 2.5 min (range, 1-4 min). There were no conversions. Postoperative morbidity included one urinary tract infection. All but one patient returned to a normal diet within 48 h. Opiates were needed a maximum of 48 h. One recipient experienced initial loss of graft function as a result of unknown causes.


CONCLUSIONS
Even at the beginning of the learning curve, operation time and warm ischemia time are significantly reduced by the hand-assisted approach, as compared with conventional LDN.
Bemelman
W A
WA
Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. w.a.bemelman@amc.uva.nl
van Doorn
R C
RC
de Wit
L T
LT
Kox
C
C
Surachno
J
J
Busch
O R
OR
Gouma
D J
DJ
D000328:Adult; D005260:Female; D006801:Humans; D007668:Kidney / Q000098:blood supply; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D013997:Time Factors; D020858:Tissue and Organ Harvesting / Q000379:methods*