Hand-assisted right laparoscopic live donor nephrectomy.
OBJECTIVE
Laparoscopic live donor nephrectomy has acquired an important role in the era of minimally invasive surgery. Laparoscopic harvesting of the right kidney is technically more challenging than that of the left kidney because of the short right renal vein and the need to retract the liver away from the right kidney. The aim of this article is to report our experience with right laparoscopic live donor nephrectomies.


METHODS
We performed a retrospective review of 28 patients who underwent right laparoscopic donor nephrectomies at our service. Operative data and postoperative outcomes were collected, including surgical time, estimated blood loss, warm ischemia time, length of hospital stay, conversion to laparotomy and complications.


RESULTS
The procedure was performed successfully in all 28 patients. The mean operative time was 83.8 minutes (range 45 to 180 minutes), with an estimated blood loss of 111.4 mL (range 40 to 350 mL) and warm ischemia time of 3 minutes (range 1.5 to 8 minutes). No donor needed conversion to open surgery and all kidneys showed immediate function after implantation. The average time to initial fluid intake was 12 hours (range 8 to 24 hours). Two cases of postoperative ileus and a case of hematoma on the hand-port site were observed. The mean postoperative hospital stay was 3 days (range 1 to 7 days).


CONCLUSIONS
Our data confirm the safety and feasibility of right laparoscopic donor nephrectomy and we believe that the right kidney should not be avoided for laparoscopic donor nephrectomy when indicated.
Branco
Anibal W
AW
Department of Urology and General Surgery, Cruz Vermelha Hospital, Curitiba, Parana, Brazil. anibal@awbranco.com.br
Branco Filho
Alcides J
AJ
Kondo
William
W
George
Marco A
MA
Maciel
Rafael F
RF
Garcia
Mariana J
MJ
D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007668:Kidney / Q000033:anatomy & histology* / Q000098:blood supply; D010535:Laparoscopy; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D012189:Retrospective Studies; D020858:Tissue and Organ Harvesting / Q000379:methods*