title: Pure laparoscopic right donor nephrectomy: step-by-step approach.
abstract: 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.
authors.affiliation: Department of Urology, University of California School of Medicine, San Francisco, California 94143-0738, USA. habahams@urol.ucsf.edu
authors.forename: Harrison M
authors.initials: HM
authors.lastname: Abrahams
authors.forename: Maxwell V
authors.initials: MV
authors.lastname: Meng
authors.forename: Chris E
authors.initials: CE
authors.lastname: Freise
authors.forename: Marshall L
authors.initials: ML
authors.lastname: Stoller
mesh_terms: D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D019520:Living Donors; D009392:Nephrectomy / Q000379:methods*