Laparoscopic donor nephrectomy: why not?
OBJECTIVE
Laparoscopic donor nephrectomy has undergone explosive worldwide growth as the method of choice for removal of living donor kidneys. However, the method does have some distinct disadvantages as well. The objective is to define real and potential difficulties with the generalized uncritical acceptance of this surgical technique.


METHODS
The literature and personal experience at the largest laparoscopic donor program were reviewed and consolidated. Critical areas of technique and management were analyzed.


RESULTS
Laparoscopic living donor nephrectomy has increased the pool of willing potential renal donors. In experienced has the recipient renal function results are equivalent to open nephrectomy.


CONCLUSIONS
There are risks in performing the operation to the donor and to the allograft. These risks are potentially catastrophic and mitigate against any casual attitudes about embarking on a laparoscopic donor nephrectomy program.
Jacobs
Stephen C
SC
Divisions of Urology and Videoscopic Surgery, Department of Surgery, University of Maryland School of Medicine, Baltimore, Maryland, USA. sjacobs@smail.umaryland.edu
Cho
Eugene
E
D002983:Clinical Competence; D003365:Costs and Cost Analysis; D005544:Forecasting; D006801:Humans; D007668:Kidney / Q000098:blood supply / Q000293:injuries / Q000601:surgery; D016030:Kidney Transplantation / Q000191:economics; D010535:Laparoscopy / Q000009:adverse effects* / Q000191:economics; D007902:Length of Stay; D019520:Living Donors; D009392:Nephrectomy / Q000009:adverse effects / Q000191:economics / Q000193:education / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D020858:Tissue and Organ Harvesting / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D014184:Transplantation, Homologous; D019737:Transplants / Q000191:economics / Q000600:supply & distribution; D016896:Treatment Outcome; D014513:Ureter / Q000293:injuries