title: Hand-assisted laparoscopic approach to renal harvest for autotransplantation.
abstract: OBJECTIVE
  To describe a laparoscopic hand-assisted approach to renal autotransplantation that allows both harvest and transplant through the same incision.
  
  
  METHODS
  Three patients underwent renal autotransplantation from May 2003 to April 2004, two for loin pain-hematuria syndrome and one for severe ureteral-stricture disease. Two patients underwent autotransplantation on the left and one on the right. Hand-assisted laparoscopy was planned such that inferomedial extension of the hand-port incision would provide adequate exposure of the iliac vessels for autotransplantation.
  
  
  RESULTS
  The average operative time was 240 minutes, the warm ischemia time was 2 minutes 43 seconds, and the hospital stay was 3 days. All three patients had successful graft function by postoperative renal scan with a mean follow-up of 7.1 months.
  
  
  CONCLUSIONS
  Hand-assisted laparoscopic renal harvest for autotransplantation can be completed with placement of the hand port such that transplantation can be accomplished through the same incision. As many of these patients have had multiple prior retroperitoneal operations, the intracorporeal hand can greatly facilitate these potentially difficult dissections with no added morbidity.
authors.affiliation: Division of Urology, University of Missouri, Columbia, Missouri 65212, USA. troxels@health.missouri.edu
authors.forename: Scott A
authors.initials: SA
authors.lastname: Troxel
authors.forename: G
authors.initials: G
authors.lastname: Ross
authors.forename: J L
authors.initials: JL
authors.lastname: Teague
mesh_terms: D000328:Adult; D005260:Female; D021501:Flank Pain / Q000601:surgery; D005500:Follow-Up Studies; D006417:Hematuria / Q000601:surgery; D006801:Humans; D016030:Kidney Transplantation / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D013577:Syndrome; D014182:Transplantation, Autologous; D014517:Ureteral Obstruction / Q000601:surgery