title: Hand-assisted laparoscopic donor nephrectomy. Ascending the learning curve.
abstract: 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.
authors.affiliation: Department of Surgery, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands. w.a.bemelman@amc.uva.nl
authors.forename: W A
authors.initials: WA
authors.lastname: Bemelman
authors.forename: R C
authors.initials: RC
authors.lastname: van Doorn
authors.forename: L T
authors.initials: LT
authors.lastname: de Wit
authors.forename: C
authors.initials: C
authors.lastname: Kox
authors.forename: J
authors.initials: J
authors.lastname: Surachno
authors.forename: O R
authors.initials: OR
authors.lastname: Busch
authors.forename: D J
authors.initials: DJ
authors.lastname: Gouma
mesh_terms: 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*