title: Hand-assisted laparoscopic nephrectomy in living donor.
abstract: OBJECTIVE
  Report the authors' initial experience with hand-assisted laparoscopic nephrectomy technique in renal donors for transplantation.
  
  
  METHODS
  Twenty-seven donors submitted to hand-assisted laparoscopic nephrectomy were retrospectively analyzed from February 2001 to June 2002. Technical aspects of the donor surgery, results, and complications, are discussed, as well as recipient's complications and outcomes.
  
  
  RESULTS
  Among 27 hand-assisted laparoscopic nephrectomies, left kidney was withdrew in 18 donors (66.6%), and right kidney in 9 (33.3%). The operative time ranged from 55 to 210 minutes (mean 132.7 + 37.6 min), and the time of hot ischemia ranged from 2 to 11 minutes (mean 4.7 + 2.5 min), with an estimated mean blood loss during the intraoperative period of 133.3 mL. Conversion to open surgery was necessary for 1 (3.7%) patient due to vascular lesion. In graft evaluation, immediate diuresis was observed in 26 (96.3%) cases, and mean serum creatinine in PO day 7 was 1.5 + 1.1 mg/dL. Renal vein thrombosis occurred in 1 (3.7%) patient requiring graft removal. Lymphocele was observed in 3 recipients (11.1%), and urinary leakage due to ureteral necrosis in 1 case (3.7%).
  
  
  CONCLUSIONS
  Hand-assisted laparoscopic nephrectomy in living donors is a safe procedure and an effective alternative to open nephrectomy. In this series, the procedure presented low morbidity after surgery providing to the recipient a good morphological and functional quality of the graft.
authors.affiliation: Division of Urology, Unit of Renal Transplantation, Cajuru University Hospital, Catholic University of Paraná (PUC - PR), Curitiba, Paraná, Brazil. lss@mps.com.br
authors.forename: Luiz S
authors.initials: LS
authors.lastname: Santos
authors.forename: André E
authors.initials: AE
authors.lastname: Varaschin
authors.forename: Fernando
authors.initials: F
authors.lastname: Meyer
authors.forename: Alcides
authors.initials: A
authors.lastname: Branco
authors.forename: Fernando
authors.initials: F
authors.lastname: Koleski
authors.forename: Ronaldo
authors.initials: R
authors.lastname: Carvalho