Renovascular complications of laparoscopic donor nephrectomy.
OBJECTIVE
To review the operative renovascular injuries related to our laparoscopic donor nephrectomy experience, since management of intraoperative renovascular complications during laparoscopic nephrectomy can present a serious challenge.


METHODS
During a 6-year period, 353 patients underwent laparoscopic donor nephrectomy. A retrospective chart review was performed to identify and evaluate the renovascular complications associated with the procedure.


RESULTS
Eight cases (2.3%) of renovascular complications were identified. Vascular injury involved the renal artery in 6 cases and the renal vein in 2 cases. The etiologies included endovascular GIA stapling failure (n = 2), surgical clip dislodgment (n = 2), and vessel laceration during dissection or stapling (n = 4). Open conversion was necessary in 6 cases (75%). No patient mortality or allograft loss occurred.


CONCLUSIONS
Laparoscopic donor nephrectomy is associated with a low incidence of renovascular complications. Laparoscopic or open surgical management may be required when problems arise to optimize donor safety and allograft survival.
Hsu
Thomas H S
TH
Brady Urological Institute and Department of Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland 21224, USA.
Su
Li-Ming
LM
Ratner
Lloyd E
LE
Kavoussi
Louis R
LR
D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D009392:Nephrectomy / Q000009:adverse effects* / Q000379:methods; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000628:therapy; D012077:Renal Artery / Q000293:injuries*; D012082:Renal Veins / Q000293:injuries*; D012189:Retrospective Studies