Pure laparoscopic right donor nephrectomy: step-by-step approach.
OBJECTIVE
Debate surrounds laparoscopic kidney procurement for right donor nephrectomy. We detail our pure laparoscopic technique of right kidney retrieval.


METHODS
We use a four-port transperitoneal approach and extract the kidney through a low Pfannenstiel incision. Important elements include: (1) dividing the triangular ligament; (2) identifying the vena cava early; (3) minimizing ureteral dissection; (4) mobilizing the kidney within Gerota's fascia; (5) dissecting the renal artery behind the vena cava; (6) cutting the extraction incision to the peritoneum; (7) applying a Hem-o-Lok and single metal clip on the artery; (8) placing the Endo-TA stapler on the renal vein adjacent to the vena cava; (9) cutting the vessels without clips/staples on the kidney side; and (10) retrieving the kidney manually.


CONCLUSIONS
This is a reliable method of right pure laparoscopic donor nephrectomy that maximizes donor benefit and cost-effectiveness. Right laparoscopic nephrectomy is likely easier with this technique and should not be avoided if it is the preferred kidney for transplantation.
Abrahams
Harrison M
HM
Department of Urology, University of California School of Medicine, San Francisco, California 94143-0738, USA. habahams@urol.ucsf.edu
Meng
Maxwell V
MV
Freise
Chris E
CE
Stoller
Marshall L
ML
D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D009392:Nephrectomy / Q000379:methods*