Hand-assisted laparoscopic right donor nephrectomy: surgical technique.
Many centers have adopted laparoscopic and hand-assisted laparoscopic (HAL) techniques for live donor nephrectomy. Currently, the majority of laparoscopic living donor kidneys are procured from the left side because of the longer renal vein and improved transplantation. However, indications exist for right donor nephrectomy. We present our technique of HAL right-sided donor nephrectomy. A key feature of our dissection is wide mobilization of adjacent structures to achieve good exposure of the right kidney and inferior vena cava. In addition, the use of the hand permits optimal positioning of the kidney for division of the renal vessels with the vascular stapler. At the time of division of the renal vein, the stapler is placed on the wall of the inferior vena cava in order to gain maximal length. This technique has allowed HAL right-sided donor nephrectomy to be performed safely when indicated.
Wang
David S
DS
Department of Urology, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
Bird
Vincent G
VG
Winfield
Howard N
HN
Rayhill
Stephen
S
D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D009392:Nephrectomy / Q000379:methods*; D017792:Surgical Stapling / Q000379:methods; D014682:Vena Cava, Inferior / Q000601:surgery